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华西医学  2011 

轻度认知功能障碍患者的神经心理学特点初步探讨

, PP. 8-11

Keywords: 轻度认知障碍,痴呆,血管性,神经心理量表

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Abstract:

【】 目的 通过比较遗忘型轻度认知障碍(amnesticmildcognitiveimpairment,aMCI)和血管性认知障碍非痴呆型(vascularcognitiveimpairment-nodementia,VCI-ND)患者及正常老年人群在简易智能精神状态检查量表(minimentalstateexamination,MMSE)、听觉词语学习测验(auditoryverballearningtest,AVLT)、画钟试验(clockdrawingtest,CDT)及临床痴呆评定量表(clinicaldementiaratingscales,CDR)中的表现,进一步分析aMCI和VCI-ND在认知损害方面的不同特点。 方法 选取首都医科大学宣武医院神经内科门诊收治aMCI患者23例及VCI-ND患者27例(CDR=0.5分),同时选取40名正常老年人(CDR=0分)作为对照组。每位受试者均进行MMSE、AVLT、CDT及CDR等神经心理学量表测查,分析以上3组被试各项神经心理学测查得分之间的差异。 结果 各组受试者的年龄、性别及受教育程度差异无统计学意义(P>0.05),具有可比性。aMCI和VCI-ND组在MMSE、CDT、即刻记忆、延迟记忆及延迟再认检测中的平均值均低于对照组,且差异均具有统计学意义(P0.05)。在延迟再认检测中,aMCI组(6.65±4.00)较VCI-ND组(8.67±2.76)再认词语数量少,两组延迟再认的得分均低于对照组(12.83±1.77),差异有统计学意义(P0.05)whichmeantcomparability.ThemeanscoresofMMSE,CDT,instantmemoryanddelayedawarenessinaMCIandVIC-NDgroupweremuchlowerthanthatinthecontrolgroup(P0.05).However,intherecallrecognitiontest,thesethreegroupshadsignificantdifferencesthescoreinpatientswithaMCI(6.65±4.00)wasmuchlowerthanthatinpatientswithVCI-ND(8.67±2.76;P<0.05),andthescoresofthetwogroupswerebothlowerthanthatinthenormalaginggroup(12.83±1.77;P<0.05). Conclusion Comparedwithnormalelderpeople,thecognitionofaMCIandVCI-NDpatientsisimpairedseverely.ThememorytestssuggestethatcomparedwithaMCIpatients,VCI-NDpatientsmayhavedifferentneuropathologicalchangesleadingtodifferentmechanismofmemoryencodingandretrieval.

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