以睡眠障碍为首要表现的阿尔茨海默病患者的临床观察

Clinical Investigation of 95 AD Patients with Sleep Disorders as Primary Manifestation

目的探讨初发睡眠障碍的老年患者与阿尔茨海默病的关系．方法对95例65～85岁初发睡眠障碍的老年患者，睡眠障碍程度采用匹兹堡睡眠质量指数量表（PQSI）评分，对以上患者同时予MMSE评分、MOCA评分、ADL量表评分、头CT或头MRI检查，随访1～3a后观察以上指标有无变化．结果以上患者有26例诊断为阿尔茨海默病，且患者PQSI分数比初诊时增加2～7分．结论睡眠初发障碍的老年患者可能是早期阿尔茨海默病的唯一表现，临床医生应重视初发睡眠障碍的老阿尔茨海默病年患者，提高早期该病的诊断率．积极改善睡眠障碍可能延缓阿尔茨海默病的进程．

Objective The purpose of this study was to explore the relationship between primary sleep disorders and Alzheimer＇s disease in senile patients. Methods In ninety-five cases of senile patients （65 to 85 years old） with primary sleep disorders, Pittsburgh sleep quality index rating scale （PQSI） was used to evaluate the MMSE, MOCA and ADL scores. All patients underwent head CT or MRI examination. Following up for one to three years, the alteration of indices above mentioned was detected. Results Among 95 cases, 26 cases were diagnosed as AD, and their PQSI scores were elevated for 2-5 scores when compared with those in preliminary diagnosis. Conclusion Primary sleep disorders in senile patients may be the exclusive manifestation of Alzheimer＇sdisease in early stage. Clinician should look upon on the primary sleep disorders in senile AD patients in that the earlier diagnosis rate of this disease should be raised. Therefore, the strategies actively ameliorated the sleep disorders may effectively postpone the process of AD.