后部皮层萎缩患者视觉障碍表现的临床分析

Clinical features of visual impairment in patients with posterior cortical atrophy

目的了解后部皮层萎缩(posterior cortical atrophy,PCA)患者的视觉特征性表现。方法采用横断面研究,收集2017年8月至2018年2月在首都医科大学宣武医院神经内科诊断为PCA的患者13例(PCA组)和阿尔茨海默病(Alzheimer’s disease,AD)患者19例(AD组),同时选取年龄匹配、无痴呆及精神疾病家族史、认知正常者14例(认知正常组)。分析3组受试者的人口学资料(年龄、受教育年限)、神经心理量表和视觉相关量表检查结果。结果 PCA组、AD组和认知正常组在年龄、受教育年限方面匹配(P>0.05);PCA组与AD组在发病年龄、病程、临床痴呆评定(clinical dementia rating,CDR)方面差异无显著性(P>0.05),具有可比性。视觉相关量表检查显示,PCA组的综合性失认测试、视觉性共济失调测试、书写测试、视空间功能测试均较AD组差(P<0.05)。结论 PCA视觉障碍主要表现为综合性失认、失写及视空间障碍。

Objective Posterior cortical atrophy(PCA)patients had various visual impairment manifestations,to understand the visual characteristics of PCA individuals.Method Thirteen patients with PCA,19 patients with early-onset Alzheimer’s disease(AD)and 14 cognitively normal individuals were enrolled in this cross-sectional study.The Subjects completed two parts of the scale(neuropsychological scale and visual correlation scale).Univariate anova was used for the comparison of demographic data(age,education years)between the three groups,and independent sample t test was used for pairwise comparison.Result PCA group,AD group and cognitive normal group were matched in age and education years.There was no statistical difference in age and course of disease between PCA group and AD group.There are no statistically significant differences between PCA group and AD group in clinical dementia rating(CDR).Visual related scale examination showed that PCA group was worse than AD group in simultanagnosia test,visual ataxia test,writing test and visual spatial functional test.Conclusion The most common deficits in PCA group are components of Simultanagnosia,agraphia and visual space dysfunction.