摘要
目的探讨阿尔茨海默病(Alzheimer's disease,AD)患者精神行为症状(behavioral and psychologicalsymptoms of dementia,BPSD)复发的危险因素和特征。方法收集102例以BPSD发作就诊的AD患者,在BPSD发作控制后进行12个月的随访。BPSD的严重程度应用神经精神量表(neuropsychiatric inventory,NPI)评估,并将NPI因子归类为情感障碍、精神病性症状和失控行为3个症状群。分析BPSD复发与先前发作的特征,复发与患者人口学资料、发病年龄、病程、认知功能、日常生活能力、基线NPI评分等因素的关系。结果 12个月内44.1%(45/102)的患者BPSD复发。Cox回归分析显示,环境改变(RR=5.42,P<0.05)、未维持服药(RR=3.13,P<0.05)和上次发作NPI评分高(RR=1.06,P<0.05)增加BPSD复发的风险;两次BPSD发作之间的症状数相关(r=0.93,P<0.05),而情感障碍评分也相关(r=0.79,P<0.05);复发的NPI总分和精神病性症状评分均低于上次发作[(18.29±2.06)vs.(20.80±3.78),P<0.05;(6.49±1.80)vs.(7.73±1.92),P<0.05)],而且两个指标在两次发作中无明显相关(P>0.05)。结论环境改变、未维持服药和先前较严重的发作是BPSD复发的危险因素;复发时精神病性症状的严重程度可能下降,但情感障碍较恒定。
Objective To explore the characteristics and risk factors of the recurrence of behavioral and psychological symptoms of dementia （BPSD） in patients with Alzheimer＇s disease （AD）. Methods A total of 102 AD patients with BPSD were followed up for 12 months after BPSD was well controlled. The severity of BPSD was measured by the Neu- ropsyehiatrie Inventory （NPI）. The 10 items of NPI were categorized into three syndromes： affeetive impairments, psychotic symptoms and lack of control disorders. The number of symptoms, NPI total score, and its sub-scores of the recurrent BPSD were compared with those at first BPSD onset. Relationships were analyzed between the recurrenee of BPSD and its potential influential factors including age, sex, onset age, course, education level, marriage status, cognitive function, ability of dai- ly living, severity of BPSD at the first BPSD onset, maintenance of antipsyehotic medications, and change of environment. Results 44. 1% （45/102） of the patients presented recurrent BPSD within 12 months. Cox regression analysis demonstrated that change of environment （ RR = 5.42, P 〈 0. 05 ） , no maintenance of antipsyehotic medication （ RR = 3. 13, P 〈 0. 05 ） , and high NPI score at first BPSD onset（ RR = 1.06, P 〈 0. 05 ） were risk factors for recurrent BPSD. The numbers of symptoms between the first BPSD onset and the recurrent onset was significantly associated （ r = 0. 93, P 〈 0. 05 ） , and so was the affeetive suh-seores （r =0. 79, P 〈0. 05）. The NPI total score （ 18.29 ±2. 06 vs. 20. 80 ±3.78, P 〈0. 05） and psychotic sub-score （6.49 ± 1.80 vs. 7.73 ± 1.92, P 〈 0. 05 ） were significantly lower in the recurrent onset than in the first BPSD. Conclusions The change in environment, no maintenance of antipsyehotie medication, and high NPI score at first BPSD onset are risk factors for the recurrence of BPSD. The severity of BPSD and its psychotic symptoms might decrease with the progress of the disease wherease affective impairments appear to be unchanged.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2011年第2期76-79,共4页
Chinese Journal of Nervous and Mental Diseases
关键词
阿尔茨海默病
精神行为症状
复发
Alzheimer＇s disease Behavioral and psychological symptom Recurrence
