阿尔茨海默病患者脑白质病变与精神行为症状的研究

Research on white matter lesion and behavioral and psychological symptoms of patients with Alzheimer′s disease

目的探讨不同脑白质病变严重程度的阿尔茨海默病(AD)患者伴发精神行为症状的差异。方法 37例AD患者采用3.0 T MRI仪检查,MRI白质高信号(WMH)采用Fazekas量表评分分级,分为无或轻度WMH组(14例)和中重度WMH组(23例),用神经精神科问卷(NPI)、简易智力检测量表(MMSE)、阿尔茨海默病评定量表-认知部分(ADAS-cog)评估基线和随访4周末精神行为症状和认知情况,将结果进行统计分析。结果无-轻度WMH组和中-重度WMH组组间年龄分别为(71.3±12.5)岁和(78.7±6.1)岁(P<0.05);两组间NPI基线和4周末评分两组间有统计学差异,中-重度组评分高于无-轻度组(P<0.05);NPI基线-4周变化值则无统计学差异,余项MMSE和ADAS-cog评分和基线-4周变化值均无统计学差异。结论阿尔茨海默病患者脑白质病变严重程度可能与伴发的精神行为症状有关。

Objective To investigate the difference in behavioral and psychological symptoms among Al-zheimers disease（AD）patients with different severity of white matter hyperintensity（WMH）. Methods A totalof 37 AD patients were enrolled and were followed-up for 4 weeks. They were checked by 3.0 T MRI at baseline,including T1,T2-weighted phase and fluid-attenuated inversion recovery sequence（FLAIR phase）. The image pro-fessionals analyzed the images and process data. The Fazekas scale was used for WMH rating. Assessment tools in-cluded the Neuropsychiatric Inventory（NPI）、MMSE and ADAS-cog. Results There were 14 patients in none-mild WMH group and 23 patients in moderate-severe WMH group. The age of two groups were 71.3 ± 12.5 and78.7 ± 6.1 years old respectively（P〈0.05）. The comparison of NPI,MMSE and ADAS-cog assessment results be-tween two groups show that there is significance difference in NPI baseline scoring and 4-week scoring. The score inmoderate-severe group w is higher than that in the none-mild group（P〈0.05）. However,the changed value ofbaseline-4-week NPI is not statistically significant. There is no significant difference between MMSE and ADAS-cog score and changed value. Conclusion Taken together,the severity of WMH may be related to behavioral andpsychological symptoms of patients with Alzheimer′s disease.