1188例具有神经影像资料的门诊老年人神经疾病病因分析

The etiology of neurological disorders in 1188 elder patients with neuroimaging at geriatric outpatientclinic

目的认识门诊老年人神经疾病的常见病因构成情况。方法从解放军总医院数据管理系统（PRIDE）提取2009年7月1日至2012年6月30日老年神经门诊有脑MRI或CT检查结果的60岁及以上年龄病例的相关信息，分析神经系统常见疾病构成比以及不同年龄段老年人的神经疾病构成的特征。结果共入选我院老年神经门诊有脑MRI或CT等影像学资料的60岁及以上老年人病例1188例，其中脑血管疾病占22．39％，轻度认知功能障碍及痴呆占15．99％，包括帕金森病、帕金森综合征及老年良性震颤的运动障碍疾病占9．09％，睡眠疾病占6．73％，精神心理疾病占6．65％，伴有神经系统症状的颈、腰椎病占10．52％。与60-69岁、70～79岁年龄组病因构成比不同，轻度认知功能障碍及痴呆、帕金森病是80岁及以上高龄和超高龄组神经疾病的主要病因。结论脑血管疾病、轻度认知功能障碍及痴呆、帕金森病等构成门诊老年人主要神经疾病，这些疾病应该成为老年神经疾病防治的重点。

Objective To investigate the etiology of neurological disorders in elderly at outpatient clinic. Methods Elderly patients aged 60 years old or more who visited the geriatric neurological outpatient clinic of PLA General Hospital from July 1, 2009 to June 30, 2012 and underwent the brain MRI or CT imaging were retrospectively analyzed. The constituent ratio of common neurological disorders in all patients and patients from different age groups were statistically analyzed based on the information from PRIDE data management system. Results A total of 1 188 patients were enrolled in this study with well documented record of complaint examination of the nerve system and brain MRI or CT imaging. Common neurological disorders in those patients were cerebrovascular disease （22.39%） , mild cognitive impairment and dementia （ 15.99% ） , movement disorders including Parkinson disease, Parkinsonism and essential tremor（9.09% ） , sleep disorders （6.73%） and psychological diseases（6.65% ）. Spinal degenerati,~e diseases accompanied by neurological symptoms also accounted for 10.52%. Less common causes in those patients were benign paroxysmal positioning vertigo （ 3. 96% ）, headache and neck pain （ 3. 28% ） , cranial nerve diseases （2. 78% ） and intracranial tumors （2.61%）. Constituent ratios of mild cognitive impairment and dementia in different age groups were associated with aging, and the same was observed with Parkinson disease. Conclusion The common neurological disorders in the geriatric outpatients are cerebrovascular disease and neurodegenerative diseases including different type of dementia and Parkinson disease. Those disorders should be focused for the prevention and treatment of the nervous system diseases in the elderly_