71例老年痴呆患者随访结果分析

A Follow-up Study among 71 Patients with Senile Dementia

目的观察药物干预对老年痴呆病程及转归的影响。方法收集确诊的老年痴呆患者共71例,随机分为药物干预组59例及未用药组12例,2年后对其进行全面随访调查,选择基线点MMSE评分(治疗前)、随访点MMSE评分(随访时)作为主要观察指标。结果失访10例,实访61例,其中死亡8例(13.3%),存活53例。主要死因为肺感染和心脑血管疾病。总体患者随访点MMSE评分较基线点评分下降,但药物干预组下降程度明显低于未用药者,药物干预组内部MMSE评分改变无统计学差异。药物干预组存活患者随访点MMSE评分较基线评分提高26例(54.2%),降低20例(41.0%),持平2例,提高者基线点评分明显高于降低者,病程明显短于降低者。轻度痴呆患者随访点评分较基线点评分平均提高(1.05±2.01)分,而中重度痴呆患者随访评分较基线评分平均降低(1.85±3.86)分,两者比较差异有统计学意义(P<0.05)。结论老年痴呆是进展型疾病,死亡率高,主要死因为肺感染和心脑血管疾病,药物干预能延缓病程发展,干预越早疗效越好。

Objective To observe the effect of pharmacological intervention on the course and prognosis in senile dementia patients. Methods A total of 71 senile dementia patients were selected. They were divided into two groups by random sampling： the pharmacological intervention group （n= 59） and the control group （n = 12）. MMSE scores were recorded at the time of registration and two years later. Results 10 patients lost in followup, 8 patients died, and only 53 patients were taken into this study. The MMSE scores of all the patients declined at two years later comparing with baseline scores. The scores of patients in pharmacological intervention group were significantly lower than those in control group. There was no significant difference in patients of pharmacological intervention group. When compared with baseline MMSE scores at two years later in pharmacological intervention group, 26 patients raised, 20 patients declined and 2 patients did not change. The baseline scores of patients whose scores raised were significantly higher than those whose scores declined. When compared with baseline scores, the scores of patients with mild dementia increased by 1.05 and the scores of patients with moderate or severe dementia decreased by 1.85. There were statistically significant differences between them. Conclusions The senile dementia was a progressive disease. The pharmacological intervention could delay its deterioration and the intervention would have a better effect when taken in earlier course of dementia.