阿尔茨海默病病人的营养状况与认知功能的关系  

Comparison of cognitive function in Alzheimer’s patients with different nutritional status

作　　者：葛建超 彭鲁[2] 郏文亭 张利丽[1] 赵英 胡秀秀[1] 董靖德[1] GE Jian-chao;PENG Lu;JIA Wen-ting;ZHANG Li-li;ZHAO Ying;HU Xiu-xiu;DONG Jing-de(Department of Geriatrics,Brain hospital affiliated to Nanjing medical university,Nanjing 210002,Jiangsu,China;Department ofLaboratory,Brain hospital affiliated to Nanjing medical university,Nanjing 210002,Jiangsu,China;Geriatric hospital of Nanjing medical university,Nanjing 210024,Jiangsu,China)

机构地区：[1]南京医科大学附属脑科医院老年医学科,江苏南京210029 [2]南京医科大学附属脑科医院检验科,江苏南京210029 [3]南京医科大学附属老年医院,江苏南京210024

出　　处：《肠外与肠内营养》2020年第6期345-349,共5页Parenteral & Enteral Nutrition

基　　金：江苏省干部保健科研课题(BJ18003)。

摘　　要：目的:比较不同营养状况对AD病人的认知功能的影响。方法:回顾性分析就诊于南京脑科医院的AD病人150例,应用微型营养评估(MNA)评估病人的营养状况;应用简短精神状态量表(MMSE)、临床痴呆评定(CDR)、阿尔茨海默病评定量表-认知(ADAS-Cog)评估病人的认知功能情况;应用日常生活能力量表(ADL)评估病人的日常生活能力;应用神经精神科问卷(NPI)评估病人的精神行为情况。结果:不同营养状况AD病人的MMSE、ADL、CDR、NPI、ADAS-cog差异有统计学意义;单因素分析发现MMSE(r=0.495,P=0.001)与MNA呈正相关,而病程(r=-0.209,P=0.001)、CDR(r=-0.400,P=0.001)、ADL(r=-0.404,P=0.001)、NPI(r=-0.332,P=0.001)、ADAScog(-0.436,P=0.001)与MNA呈负相关。二元Logistic回归分析发现MMSE[OR=0.77,95%CI:0.61~0.95,P=0.031]与营养异常状态显著相关。结论:营养状态差的AD病人其认知功能下降更显著,日常生活能力损害更严重,伴发精神行为异常的发生率更高。Objective:To compare the effects of different nutritional status on the cognitive function of Alzheimer’s disease(AD)patients.Methods:A retrospective analysis of 150 patients with AD were admitted to Nanjing Brain Hospital.The nutritional status of the patients was evaluated by the Mini Nutritional Assessment(MNA);The patient’s cognitive function was assessed by the Minimum Mental State Examination(MMSE),Clinical Dementia Rating(CDR),and Alzheimer’s Disease Assessment Scale-Cognitive section(ADAS-Cog);using the Activity of Daily Living(ADL)to assess the patient’s ability of daily living;using the Neuropsychiatric Inventory(NPI)to assess the patient’s mental behavior Happening.Results:The differences in MMSE,ADL,CDR,NPI,ADAS-cog of AD patients with different nutritional status were statistically significant;Univariate analysis found that MMSE(r=0.495,P=0.001)was positively correlated with MNA,while Course of disease(r=-0.209,P=0.001),CDR(r=-0.400,P=0.001),ADL(r=-0.404,P=0.001),NPI(r=-0.332,P=0.001),ADAS-cog(-0.436,P=0.001)was negatively correlated with MNA.Binary Logistics regression analysis found that MMSE[OR=0.77,95%CI:0.61~0.95,P=0.031]was significantly related to abnormal nutritional status.Conclusion:AD patients with poor nutritional status have a more obvious decline in cognitive function,more serious impairment of daily living ability,and higher incidence of abnormal mental behavior.

关 键 词：阿尔茨海默病 营养不良 认知功能 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R459.3[医药卫生—临床医学]