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对比分析

Comparison of the behavioral and psychiatric symptoms in elderly patients between Alzheimer's disease and vascular dementia

目的分析老年性阿尔茨海默病(AD)与血管性痴呆(VD)患者的行为和精神症状,旨在为两种疾病的鉴别诊断提供参考依据。方法前瞻性选取神经内科2013-01~2016-02收治的49例AD患者和同期收治的55例VD患者为研究对象,并采用简易智能精神状态检查量表(MMSE)评分、阿尔茨海默病病理行为评分表(BEHAVE-AD)评分及世界卫生组织-加利福尼亚大学听觉词语学习测验(WHO-UCLA AVLT)评分对两组患者的精神和行为症状进行评估。结果 AD组在攻击行为、行为紊乱发生率明显高于VD组(P<0.01),但情感障碍发生率明显低于VD组(P<0.01)。AD组妄想和偏执、攻击行为、恐惧和焦虑、行为紊乱BEHAVE-AD评分虽高于VD组,但组间比较差异无统计学意义(P>0.05);VD组幻觉、情感障碍及日夜节律紊乱BEHAVE-AD评分虽高于AD组,但组间比较差异无统计学意义(P>0.05)。两组MMSE评分比较,AD患者在记忆力、语言方面均明显低于VD组(P<0.01),而在注意力方面明显高于VD组,两组比较差异有统计学意义(P<0.05);AD组虽在定向力、空间感方面高于VD组,但两组比较差异无统计学意义(P>0.05)。两组WHO-UCLA AVLT评分比较,VD组延时记忆和长时记忆分值较AD组明显偏高(P<0.01)。结论 AD和VD患者均存在精神和行为症状的异常表现,且存在一定差异,对两组疾病的鉴别诊断有一定的参考价值。

Objective To explore the behavioral and psychiatric symptoms of Alzheimer＇s disease and vascular dementia,and to provide the reference for the differential diagnosis of the two diseases. Methods In the department of neurology of our hospital from January 2013 to February 2016,49 cases of AD patients（AD group） and55 cases of VD patients（VD group） were collected. MMSE scores,BEHAVE-AD scores WHO-UCLA AVLT scores were evaluated and compared between the two groups. Results The aggressive behavior and behavioral disorder rate in the AD group were significantly higher than those in the VD group（P〈0. 05）,and the incidence of affective disorder of the AD group was significantly lower than that of VD group（P〈0. 05）. In terms of MMSE scores in the AD patients,the scores of memory and language were significantly lower than those in the AD patients（P〈0. 05）,while the scores of concentration were significantly higher than those in AD patients. In terms of WHO-UCLA AVLT scores,the scores of delayed memory a long-term memory in VD patients were significantly higher than those in AD patients（P〈0. 05）. Conclusion Both AD and VD patients have the symptoms of mental and behavioral disorders and some differences in the symptoms between them,which has a certain reference value for differentially diagnosing the two diseases.