老年性阿尔茨海默病与血管性痴呆患者的行为和精神症状的比较

Clinical analysis of behavioral and psychological symptoms in Alzheimer's disease and vascular dementia

目的探讨阿尔茨海默病痴呆患者的行为和精神症状。方法选取本院2011年5月至2015年5月诊治的痴呆性老年患者80例,其中血管性痴呆(VD)患者40例为VD组,阿尔茨海默病(AD)患者40例为AD组,均行AD行为评分表(Behave-AD)评定,比较两组患者的行为和精神症状。结果 AD组患者偏执和妄想发生率、行为紊乱发生率、攻击行为发生率、焦虑和恐惧发生率均明显高于VD组,AD组患者偏执和妄想评分、行为紊乱评分、攻击行为评分、焦虑和恐惧评分、总评分均明显高于VD组,差异有统计学意义(P<0.05)。AD组患者幻觉发生率高于VD组,AD组患者日间节律紊乱发生率、情感障碍发生率均低于VD组,AD组患者幻觉评分高于VD组,AD组患者日间节律紊乱评分、情感障碍评分均低于VD组,但差异无统计学意义(P>0.05)。结论 AD患者偏执和妄想、行为紊乱、攻击行为、焦虑和恐惧等病症较为严重,其发生机制可能与AD患者存在较明显的额-枕叶萎缩有关。

Objective To investigate behavioral and psychological symptoms in elderly patients with dementia. Methods 80 elderly patients with dementia were selected in hospital from May 2011 to May 2015. 40 patients were vascular dementia as control group. 40 patients were Alzheimer＇s disease as observation group. Patients were assessed by scale of behavioral pathology in Alzheimer ＇ s disease（ Behave-AD）. Behavioral and psychological symptoms were compared between two groups. Results Incidence of paranoia and delusions; incidence of behavior disorders; incidence of aggressive behavior; incidence of anxiety and fear in observation group were significantly higher than control group. Paranoia and delusions score; behavior disorder score; aggressive behavior score; anxiety and fear score in observation group were significantly higher than control group. Differences were statistically significant（ P〈0.05）. Incidence of illusion in observation group was higher than control group. Incidence of diurnal rhythm disorder; incidence of affective disorders in observation group were lower than control group. Illusion score in observation group was higher than control group. Diurnal rhythm disorder score; affective disorder score in observation group were lower than control group.Differences were not statistically significant（ P〉0.05）. Conclusion Incidence of behavioral and psychological symptoms is higher in elderly patients with dementia. Clinical manifestations of dementia patients in different types are different,which should pay close attention.