路易体痴呆14例的临床分析  

Lewy body dementia:a clinical analysis of 14 cases

作　　者：郭丹丹 柏雪[2] 张鹏[2] 杜秀娟[3] 胡风云[2] 续旭 GUO Dandan;BAI Xue;ZHANG Peng;DU Xiujuan;HU Fengyun;XU Xu(Graduate School,Shanxi University of Traditional Chinese Medicine,Taiyuan,Shanxi 030000,China;Department of Neurology,Shanxi People's Hospital,Taiyuan,Shanxi 030000,China;Department of Encephalopathy,Shanxi Hospital of Traditional Chinese Medicine,Taiyuan,Shanxi 030000,China)

机构地区：[1]山西中医药大学研究生学院,山西太原030000 [2]山西省人民医院神经内科,山西太原030000 [3]山西省中医院脑病科,山西太原030000

出　　处：《安徽医药》2022年第6期1141-1143,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨路易体痴呆病人的临床特征。方法对2015年1月至2019年5月在山西省人民医院诊断的14例路易体痴呆病人的临床资料进行回顾性分析。结果14例病人中男性9例(64.3%),女性5例(35.7%),年龄范围为55~83岁。首发症状中包含视幻觉者占7.1%,帕金森病症状者占42.9%,认知功能障碍者占57.1%。临床表现中,14例路易体痴呆病人均有认知功能障碍,其中64.3%病人其认知功能障碍呈现出波动性,86%病人有帕金森病症状,79%病人出现视幻觉,在其支持症状中,14%病人有自主神经功能障碍。93%病人有精神症状。14例病人核磁均表现为脑缺血或脑萎缩。随访结束,8例病人卧床,4例病人病情稳定,2例病人死亡。结论路易体痴呆多在50岁以后发病,以波动性认知功能障碍,视幻觉,帕金森病症状为首发表现,其进展迅速,核磁检查没有特异性表现,目前尚缺乏有效药物治疗,以对症支持治疗为主。Objective To explore the clinical characteristics of patients with Lewy body dementia.Methods A retrospective analysis was made of the clinical data of 14 patients with Lewy body dementia diagnosed in Shanxi People's Hospital from January 2015 to May 2019.Results Among the 14 patients,there were 9 males(64.3%)and 5 females(35.7%),aged between 55 and 83 years old.Initial symptoms included visual hallucinations(7.1%),,symptoms of Parkinson's disease(42.9%)and cognitive impairment(57.1%).As for the clinical manifestations,all the 14 patients had cognitive impairment,of whom 64.3%showed a fluctuation of cognitive impairment,86%had Parkinson's symptoms and 79%had visual hallucinations.Among the supportive symptoms,14%had autonomic nervous dysfunction,93%had mental symptoms,and MRI results of all the 14 patients showed cerebral ischemia or brain atrophy.At the end of follow-up,8 patients were bedridden,4 patients were in stable condition,and 2 patients died.Conclusions Lewy body dementia usually occurs after the age of 50,with fluctuating cognitive impairment,visual hallucination and Parkinson-like symptoms as initial manifestation.Its progress is rapid,and there is no specific manifestation found in magnetic resonance imaging.At present,there is still no effective drug therapy,so symptomatic support treatment is mainly used.

关 键 词：痴呆 认知功能障碍 锥体外束 脑缺血 LEWY体病 路易体痴呆 诊断 

分 类 号：R749.13[医药卫生—神经病学与精神病学]