中重度阿尔茨海默病患者的神经心理学症状研究

study on clinical neuropsychology in Alzheimer's diease under moderate and severe state

目的:用神经心理学的检测工具对中度和重度阿尔茨海默病(Alzheimer's diease,AD)患者进行测试,比较不同严重程度AD患者的认知和精神行为障碍的特点。方法:采用MMSE、AVLT、ADAS-cog对中度和重度AD患者进行认知功能测试,用ADL、NPI对其非认知功能进行评定。结果:随病程的延长,AD患者的病情加重。重度AD患者的MMSE、AVLT、ADAS-cog、ADL、NPI得分均较中度AD患者明显差。在MMSE测试中,两者在时间定向、计算、记忆力、语言、运用和视空间技能五个亚项上差异均有显著性(P<0.05)。在AVLT测试中,两者的即刻记忆和延迟记忆差异均存在显著性(P<0.05)。在ADAS-cog测试中,两者在指令的回忆、单词回忆、找词困难和语言理解四个亚项上差异有显著性(P<0.05)。在ADL中,躯体生活自理方面,两者差异无显著性(P>0.05);在工具性日常生活活动方面,两者差异有显著性(P<0.05)。在神经精神症状上,重度AD患者在淡漠、异常行为方面发生率均较高。结论:总体来说,AD患者的病情越重,认知功能和生活自理能力越差,精神症状越重,但不同症状差异不同。

Objective：Use neuropsychological testing tool to detect moderate and severe state Alzheimer＇s patients,for comparing the differences of cognitive and mental-behavioural disor-ders between them.Methods：Use MMSE,VLT and ADAS-cog scales to test cognitive function,use ADL and NPI scales to test non-cognitive function.Results：With the course of disease extending,the severity growing.The performence of ADAS-cog,AVLT,MMSE,ADL and NPI in severe AD patients was poorer than that in the moderate ones.In MMSE test,every performance of the five items in severe-state AD patients was lower than that in the moderate-state AD ones.The difference was significant（P0.05）.In AVLT tests,the difference of immediate memory and delayed memory between the two states of AD was significant.In ADAS-cog test,the performance of recall memory for instructions,word memory,difficulty in finding words or language comprehension was poor in severe-state AD patients than those in the moderate-state AD ones.The difference was significant（P0.05）.In ADL scale,body self-care had no significant difference（P0.05）.Instrumental actiities of daily living had significant difference（P0.05）.In severe-state AD patients there was higher incidence in abnormal behavior and indifference performance.Conclusion：Overall,in AD patients with the severity growing,the cognition function and self-care skills drop,the psychiatric symptoms aggravate.But there also is difference in different symptoms.