阿尔茨海默病神经精神症状评估量表评价及临床应用的初步研究  

Evaluation and clinical application of NPSA scale for Alzheimer’s disease

作　　者：郭艳娥[1] 郝卫军 解恒革[1] 尚延昌[1] 孙永安[3] 王华丽[4] Guo Yan'e;Hao Weijun;Xie Hengge;Shang Yanchang;Sun Yong'an;Wang Huali(Department of Neurology,National Clinical Research Center for Geriatric Diseases,Second Medical Centre of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心神经内科国家老年疾病临床医学研究中心,北京100853 [2]中共中央办公厅警卫局保健处 [3]北京大学第一医院神经内科 [4]北京大学第六医院临床研究室

出　　处：《中华老年心脑血管病杂志》2022年第8期789-792,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家重点研发计划项目(2019YFC0118201)。

摘　　要：目的评价神经精神症状评估(NPSA)量表的信效度评估,探索阿尔茨海默病(AD)患者精神行为症状特点。方法纳入2018年8月~2019年3月全国255家医院门诊诊断明确的AD患者4677例,进行NPSA量表评估,依据样品聚类分析结果分为分组1(2566例)、分组2(1063例)和分组3(1048例),评估NPSA量表的内部一致性,用变量聚类分析(R型聚类分析)对NPSA量表的15个条目进行聚类。结果NPSA量表Cronbach的标准α系数为0.7500,在AD患者中NPSA量表阳性率最高的为第14条(65.21%)、第2条(63.87%)和第1条(62.45%),有8个条目阳性率在50%以上,认知症状越重,精神行为症状阳性率越高。分组1 NPSA量表所有15个条目阳性率均明显低于分组2和分组3(P<0.05)。分组2 NPSA量表第1~2条、第6~9条、第13~14条阳性率明显低于分组1和分组3(P<0.05),分组3 NPSA量表有5个条目阳性率最高,包括第3~5条、第11~12条。结论NPSA具有良好的信效度,能够用于AD患者精神行为症状的筛查,AD患者淡漠发生率最高,不同个体间的异质性较大。Objective To evaluate the reliability and validity of Neuropsychiatric Symptom Assessment(NPSA) scale and explore the characteristics of neuropsychiatric symptoms in patients with AD.Methods NPSA scale was tested for 4677 AD patients diagnosed in the out-patient departments from 255 hospitals in China during August 2018 and March 2019.According to the results of sample cluster analysis, the patients were divided into group 1(n=2566),group 2(n=1063) and group 3(n=1048).The internal consistency and structural validity of NPSA scale were evaluated.The 15 items of NPSA scale were clustered by variable cluster analysis(R-type cluster analysis).Results In the internal consistency analysis of NPSA scale, the Cronbach’s alpha coefficient was 0.7500.In AD patients, Items 14(65.21%),2(63.87%) and 1(62.45%) obtained the highest positive rate, and 8 form the 15 items had the positive rate over 50%.The positive rates of psychiatric symptoms was increased with the severity of cognitive impairment.The positive rates of all 15 items of NPSA scale were significantly lower in group 1 than group 2 and group 3(P<0.05).The positive rates of Items 1-2,6-9,13-14 were obviously lower in group 2 than group 1 and group 3(P<0.05).Group 3 got the highest positive rates for 5 items(Items 3-5,11-12) among the 3 groups.Conclusion NPSA scale has good reliability and validity, and can be used to screen neuropsychiatric symptoms in AD patients.The incidence of apathy is the highest in AD patients, but there is great heterogeneity among different individuals.

关 键 词：阿尔茨海默病 精神状态检查表 认知 聚类分析 

分 类 号：R749.16[医药卫生—神经病学与精神病学]