轻度阿尔茨海默病患者记忆障碍的临床研究

The clinical models of memory impairment in mild Alzheimer’s disease

目的 探讨轻度阿尔茨海默病患者记忆障碍的临床特点及损害类型。 方法 轻度阿尔茨海默病患者 3 0例 ,轻度认知功能障碍患者 2 0例 ,健康老年人 2 0名 ;语言工作记忆和注意力测定应用韦氏数字广度测验进行 ;非陈述性记忆测定应用改良后SegwinGaddand型板测验 ;情节性记忆测定应用简历记忆访谈测验 ;词语性记忆测查应用临床记忆量表及ADAS cog量表。 结果 与健康老年人组比较 ,在记忆损害类型中 ,轻度阿尔茨海默病组及轻度认知功能障碍组语言工作记忆均受到损害 ,组间差异有显著性 (t =2 3 4 2 ,P <0 0 5) ;非陈述性记忆两组间差异无显著性 (t =1 653 ,P >0 0 5) ,且几乎不受损害。轻度阿尔茨海默病患者组与轻度认知功能障碍患者组之间 ,情节性记忆组间差异有显著性 (t =3 469,P <0 0 1) ,而词语性记忆中 (除即刻回忆、物品命名外 )组间差异有显著性 (t =2 618,P <0 0 5)。 结论 轻度阿尔茨海默病患者临床最早出现的并具特异性的记忆损害类型为情节性记忆和词语性记忆 。

Objective To assess the clinical models of memory impairment in the diagnosis of Alzheim er's disease at early stages. Methods Neuropsychological assessments includes working memory, declarative and nondec larative memory, episodic memory, semantic memory obtained in 30 patients with m ild AD, 20 patients with mild cognition impairment (MCI) and 20 aging control su bjects. Results Episodic memory(t=3 469, P<0 01)was the best sensitivity in discri minating AD patients from aging control subjects and MCI patients. Semantic memo ry (t=2 618, P<0 05)was more sensitive in discriminating AD patients from aging control subjects and MCI patients beside of the immediately recall a nd naming. There was no difference in working memory(t=1 142, P>0 05 ) and nondeclarative memory (t=1 653, P>0 05)between AD and aging c ontrol subjects or MCI patients. Conclusions Episodic memory impairment and semantic memory impairment beside the immediat ely recall and naming are the earliest and most pervasive memory deficit in mild AD patients, and episodic memory impairment is more specific than semantic memo ry impairment for the diagnosis of AD.