情感障碍患者一级亲属阿尔茨海默病患病风险研究

A study of the risk for Alzheimer＇s disease in first-degree relatives of patients with affective disorders

目的探讨情感障碍患者一级亲属中阿尔茨海默病（Alzheimer’Sdisease，AD）患病率，以评估情感障碍家系中AD的患病风险。方法收集符合“DSM—IV—TR”诊断标准的情感障碍患者（情感障碍组）及其健康配偶（对照组）各109例，一级亲属人组标准为年龄≥55岁的父母和同胞。对可疑者应用神经心理评估、影像学和临床检查后，再根据美国神经病语言障碍和中风研究所及阿尔茨海默病与相关障碍协会（NINcDsADRDA）标准进行AD的诊断。结果情感障碍组一级亲属284例，对照组一级亲属274例，两组一级亲属平均年龄、性别分布差异无统计学意义。情感障碍患者的284例一级亲属中有lO．6％（30／284）被诊断AD，对照组274例一级亲属中有4．4％（12／274）被诊断AD，两组AD患病率差异有统计学意义（x=-7．47，p-0．006）；其中，情感障碍各亚型中双相障碍和抑郁障碍患者一级亲属AD患病率分别为11．2％（14／125）和20．0％（15／75），均高于对照组一级亲属AD患病率4．4％（12／274）（x2=6．80、20．56，OR=2．60、4．63，P=0．009、0．001），而躁狂发作患者一级亲属AD患病率为1．1％（1／87），与对照组一级亲属AD患病率4．4％（12／274）比较，差异无统计学意义（x2=1.99，P=0．159）。结论情感障碍患者尤其是抑郁症和双相障碍患者的一级亲属AD患病风险车奁高。

Objective To investigate the prevalence of Alzheimer＇s disease fAD） in first-degree relatives of patients with affective disorders, and to evaluate the risk of AD in first-degree relatives of the patients with affective disorders. Methods Patients with affeetive disorders meeting ＂DSM-IV- TR＂ criteria （affective disorders group） and their healthy spouses （eonrol group） were recruited in this study （n 109 each）. The first-degree relatives inclusion criteria were biological relatives of both probands aged over 55 years. Subjects were investigated by neuropsychological assessment, imaging and clinical examinations, and were diagnosed as AD according to the criteria of the United States of America neuropathy language disorders and stroke research institute and Alzheimer＇s disease and Related Disorders Association （N1NCDS-ADRDA）. Results 284 first-degree biological relatives of affective disorders patients and 274 first-degree relatives of control group were selected. There were no statistically significant differences in demographic characteristics of the first-degree relatives between the two groups. The prevalence of Alzheimer＇s disease in the first-degree relatives had a significant difference between affective disorders group and control group [ 10.6~ （30/284） vs. 4.4~/oo （12/ 274）, ）~ =7.47,P=0. 006]. The prevalence of AD in the first-degree relatives was higher in bipolar disorder and depressive disorder patients than in control group [11.2~/oo （14/125） vs. 4.4%（12/274）, 20.0% （15/75） vs. 4.4%（12/274）, Z2=6.80, 20.56,0R=2.60, 4.63,bothP〈0.05], while there was no significant difference in the prevalence of AD in the first degree relatives between mania patients and control group [1.1% （1/87） vs. 4.4% （12/274）,Z2：1.99,P〉0.05]. Conclusions There is a high risk for Alzheimer＇ s disease in first degree relatives of patients with affective disorders, particularly in first degree relatives of patients with depression and bipolar disorders.