脑中风后痴呆病程发展特点探讨

A probe to the developing features of post-stroke dementia

目的探讨脑中风后痴呆(PSD)的亚型分类及其发病特点。方法通过随访并行神经心理学等检查收集到32例符合研究条件的病例,依据NINCDS-ADRDA诊断标准诊断可疑AD型,依据NINDS-AIREN诊断标准诊断可疑VaD型,应用统计学方法比较两个亚型发生痴呆的时间。结果经过Kaplan-meier生存分析,可疑AD型的平均发病时间为17.67(±3.10)个月,可疑VaD型的平均发病时间为28.80(±2.66)个月,两者的发病病程显著不同(P=0.009)。结论脑中风后痴呆的发病率逐渐上升,且由中风后2年内的可疑AD型为主转变为以2～4年间的可疑VaD型为主。

Objective To study the subtypes and developing features of post-stroke dementia （PSD）. Method Collecting 32 cases by following-up and neuropsychological tests, trying to divide their subtypes of possible AD and possible VaD in terms of NINCDS-ADRDA and NINDS-AIREN respectively, and then analyzing the incidence time. Result According to the Kaplan-meier analysis, the mean incidence time of possible AD is 17.67 （ ± 3.10） months, and that of possible VaD is 28.80（ ± 2.66 ）months. The difference between the two subtypes is significant（ P=0.009 ）. Conclusion The incidence of dementia increased significantly, shifting from an possible AD-type predominantly in the first 2 years to a possible VaD-type predominantly in 2 to 4 years.