语义性痴呆的临床特点

Study on the clinical features of patients with semantic dementia

目的通过分析5例语义性痴呆(semantic dementia,SD)患者的临床资料,结合文献报道,探究SD患者临床特点。方法对于我院收诊5例语义性痴呆患者一般临床信息、病史查体、神经心理及神经影像学检查结果进行回顾性分析及相关文献回顾。结果 患者平均发病年龄为63.8岁,神经心理检查均显示有不同程度认知功能障碍MMSE 7~28分,MOCA 2~15分;4例患者均有命名能力下降,命名正确率为4%~31%;1例患者出现精神行为异常NPI 18分;患者日常生活能力损害较轻ADL 22~31分。患者头MRI均显示双侧不对称性颞叶皮层萎缩,其中4例以左侧为重。结论 语义性痴呆患者日常生活能力保留较好,偏重左侧萎缩SD语言障碍较为突出,偏重右侧萎缩SD更容易出现精神行为症状。

Objective To explore the clinical features through analyzing the clinical data of 5 patients with semantic dementia(SD)and reviewing the literatures.Methods We retrospectively analyzed the history,general data,neuropsychological assessment and imaging data of 5 patients with semantic dementia at our hospital and reviewed the literature on SD research.Result The average age of onset was 63.8 in five SD patients.The psychological examinations showed the cognitive dysfunction to certain degrees.The scores of MMSE and MOCA were between 7 and 28 and between 2 and15,respectively.Four cases had a decline in naming test and the correct rate was 4%~31%.One case presented behavioral and psychological symptoms and NPI score was 18.The patient's daily living ability showed a relatively slight damage and the scores of ADL were between 22 and 31.Brain MRI showed atrophy in the left temporal lobe in 4 patients and in the right side in 1 patient.Conclusions The patients with SD well preserve the daily life ability.SD patients with left temporal lobe atrophy tend to have language problems,while those with right temporal lobe atrophy are more likely to develop behavior disorders.