阿尔茨海默病合并白质病变患者的认知功能障碍特点分析

Charactistics of cognitive impairment in the patients with both Alzheimer disease and white matter lesions

目的探讨阿尔茨海默病(AD)合并白质病变(WML)患者危险因素和认知功能障碍特点。方法临床收集轻度阿尔茨海默病患者77例,根据MRIT2加权像是否合并WML分为单纯AD组34例和阿尔茨海默病合并WML组43例,以78名年龄和教育程度相匹配的认知正常老年人为对照组,分别进行MMSE、数字广度测验、词语延迟回忆测验、词语流畅性测验、积木测验和画钟测验。结果 (1)与对照组和单纯AD病组相比,AD合并WML组高血压病和房颤的比例明显升高(P<0.05)。(2)与对照组相比,单纯AD组和AD合并WML组MMSE、数字广度测验、词语延迟回忆测验、词语流畅性测验、积木测验和画钟测验评分均明显降低(P<0.05)。(3)与单纯AD组相比,AD合并WML组词语流畅性测验、积木测验和画钟测验评分均显著降低(P<0.05)。结论高血压病、糖尿病和房颤可能是AD合并WML的危险因素;WML可加重AD患者视空间和执行功能障碍。

Objective To investigate the characteristics of vascular risks and cognitive impairments in the patients with both Alzheimer disease（AD）and white matter lesions（WML）.Methods 77 mild AD patients were classified into pure AD group and AD with WML group according to MRI.78 old individuals with normal cognition were regarded as controll group.All patients＇cognitive status were assessed with MMSE,digit span test,auditory verbal delayed memory test,word fluency test,block-test and clock-drawing test.Results ① The prevalence of hypertention and atrial fibrilation in AD with WML group increased significantly than those in pure AD group and control group.② Compared with control group,the patients in pure AD group and in AD with WML group had lower scores in MMSE,digit span test,auditory verbal delayed memory test,word fluency test,block-test and clock-drawing test.③ Compared with pure AD group,the patients in AD with WML group had lower scores in word fluency test,block-test and clock-drawing test.Conclusion Hypertention,diabetes mellitus and atrial fibrilation may be the risk factors of the patients with both AD and WML.WML may promote visual-spatial and executive impairment