摘要
目的:通过对遗忘型轻度认知功能损害(简称轻度认知功能损害)和极轻度阿尔茨海默病的入组条件进行严格的量化界定,分析两组受试者的认知功能和临床表现的差异。方法:所有病例来源于2004-04/12在复旦大学附属华山医院神经内科“记忆障碍”门诊的就诊者,全部在神经心理研究室完成全套评估。根据诊断标准分为轻度认知功能损害组(n=60),极轻度阿尔茨海默病组(n=32)和轻度阿尔茨海默病组(n=32),另有来源于体检和社区离退休的正常老人60例作为对照。分别采用简明精神状态量表、听觉词语记忆测验、逻辑记忆测验、Stroop色词测验、Rey-Osterrich复杂图形测验、连线测验、言语流畅性测验和临床痴呆量表等评定总体认知功能、记忆、语言、注意、视觉空间能力、执行功能和临床特征。结果:所有调查对象全部进入结果分析。①临床痴呆量表记忆项和总分在轻度认知功能损害组与极轻度阿尔茨海默病组之间比较差异有显著性(P<0.01);②轻度认知功能损害受试的情景记忆功能全面减退,其听觉词语记忆测验词语记忆变化曲线与极轻度及轻度阿尔茨海默病相类似,而与正常老人组不同;③除了STROOP色词测验卡片C耗时数和连线测验-A耗时数,其余非记忆指标在轻度认知功能损害组与极轻度阿尔茨海默病组之间差异有显著性(P<0.01～0.05);反映执行功能的Stroop色词测验卡片C正确数和言语流畅性测验总分尤其明显。结论:轻度认知功能损害是正常衰老与极轻度阿尔茨海默病的连续演变过程的中间环节,临床痴呆量表总分、延迟回忆得分和执行功能测验是鉴别轻度认知功能损害与极轻度阿尔茨海默病患者的有效方法。
AIM： To analyze the differences in cognitive function and clinical situation between two groups by strictly settle the grouping condition of atonestic mild cognitive impairment （aMCI） and mild Alzheimer＇s disease （AD）. METHODS： All subjects were selected from the Clinic of Dysmnesy, Department of Neurology, Huashan Hospital Affiliated to Fudan University between April and December 2004, who had accomplished full set of evaluation in the Institute of Neuropsychology. Subjects were divided into aMCI group （n=60）, very mild AD group （n=32） and mild AD group （n=32）. Another 60 old men selected from health examination and community were taken as control. The total cognitive function, memory, attention, language, visual spatial ability, executive function and clinical features were assessed by MMSE, Recall of Auditory Verbal Learning Test, Stroop Color Words Test, Rey-Osterrich Complex Figure Test, Trail Making Test, Test of Fluency in Language and clinical dementia rating respectively. RESULTS： All subjects were involved in the .analysis of results. ①There were great differences in scores of memory items and total score of clinical dementia rating between aMCI group and very mild AD group （P 〈 0.01）. ②The episodic memory function of patients in the aMCI group overall decreased, whose curve of Auditory Verbal Learning Test was similar to that of very aMCI group and aMCI group, whereas it differed from the normal control group. ③Except the time consuming of C card in Stroop Color Words Test and the time consuming of A in Trail Making Test, other nonmemory indicators were greatly different between aMCI group and mild AD group （P〈 0.01-0.05）. The total scores of C card in Stroop Color Words Test, which can refrect the executive function and Test of Fluency in Language were significant. CONCLUSION： aMCI is the intermediate link in the continuous developing process from normal aging to mild AD, and the total score of clinical dementia rating, the score of delayed recall and the test of exeutive function are the effective ways to discriminate aMCI from mild AD.
出处
《中国临床康复》
CSCD
北大核心
2006年第26期4-6,共3页
Chinese Journal of Clinical Rehabilitation
