《中国康复理论与实践》

《中国康复理论与实践》 ›› 2002, Vol. 8 ›› Issue (07): 388-390.

• 专题研究 • 上一篇    下一篇

血管性痴呆的神经心理学研究

孙葳; 王荫华   

  1. 北京大学第一医院神经内科 北京市 100034
  • 收稿日期:2002-05-16 出版日期:2002-07-25 发布日期:2002-07-25

Neuropsychological performances of vascular dementia

SUN Wei,WANG Yin-hua   

  1. Department of Neurology,Beijing University First Hospital,Beijing 100034,China
  • Received:2002-05-16 Published:2002-07-25 Online:2002-07-25

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被引次数

26

摘要： 目的研究血管性痴呆(VD)的神经心理学表现及不同痴呆严重程度时的变化规律。方法对39例符合美国国立神经病语言障碍卒中研究所和阿尔茨海默病及相关疾病协会(NINDS AIREN)诊断标准的“很可能的VD”患者进行了简易精神状态检查表 (MMSE)、Blessed痴呆量表(BDS)、临床记忆量表和韦氏成人智力量表(中国修订版)(WAIS RC)、临床痴呆评分 (CDR)等神经心理学量表检查,用有关亚项表示定向力、记忆、语言、视空间、认知等神经心理学功能和社会 生活能力、个人自理能力、人格改变。用CDR评定VD严重程度。结果MMSE时间定向力亚项、记忆商,WAIS RC数字广度、木块图、图形拼凑、算术亚项,BDS社会生活能力、个人自理能力亚项在轻、中、重度组两两之间有统计学差异(P<0.05)。MMSE语言亚项、语言智商和WAIS-RC领悟亚项在中、重度组和轻、重度组之间有统计学差异(P<0.05)。MMSE地点定向力亚项、WAIS RC相似亚项在轻、重度组之间有统计学差异(P<0.05)。MMSE即刻回忆、延迟回忆、画图、简单计算亚项,BDS人格改变亚项在轻、中、重度组两两之间无显著性差异(P>0.05)。结论轻度VD表现为定向力、记忆、语言、视空间、认知能力、社会生活能力、个人自理能力全面降低和人格改变,随着痴呆加重,各项变化速度并不一致。人格改变与VD严重程度关系不大。轻至中度、中至重度VD,部分认知能力尤其是曾经习得的知识的下降速度相对较慢,其余各方面均继续降低。

关键词: 痴呆, 血管性, 神经心理学

Abstract: ObjectiveTo detect the neuropsychological performances of vascular dementia(VD) and the varied patterns when the severity of VD progressed. Methods39 patients who fulfilled with National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer's Diseases and Related Disorders Association(NINDS AIREN) criteria for "probable vascular dementia"were assessed with the neuropsychological scales, including Mini Mental State Examination (MMSE), Blessed Dementia Scale (BDS), Clinical Memory Scale, Wechsler Adult Intelligence Scale Revised China (WAIS-RC) and Clinical Dementia Rating (CDR), to measure the change of orientation to time and place, memory, language, visuospatial skills, cognitive function, personality characteristics, the activities of social and daily living and self maintenance. Patients were divided into mild, moderate and severe categories according CDR scores.ResultsAmong mild, moderate and severe categories, significant differences (P<0.05) were detected in the following subtests: orientation to time of MMSE, digit span, block design, object assembly, arithmetic of WAIS-RC, memory quotient, the activities of social and daily living and self maintenance of BDS. In moderate/severe and mild/severe categories, significant differences (P<0.05) were detected in the MMSE language subtest, WAIS-RC comprehension subtest and verbal intelligence quotient. Significant differences were detected in MMSE orientation to time subtest and WAIS RC similarities subtest only between mild/severe categories (P<0.05). In the MMSE immediate or delayed recall, drawing, simple calculation subtests, and BDS personality subtest, no significant differences were detected among mild, moderate and severe categories (P>0.05). Conclusions Patients with mild VD showed general deterioration of orientation, memory, language, visuospatial skills, cognitive function, personality characteristics, the activities of social and daily living and self maintenance. However, the speed of deterioration of each item was different when the severity of VD progressed. No close correlation was observed between personality characteristics alteration and the severity of VD. From mild to moderate and moderate to severe VD, the speed of deterioration of part of the cognitive function, especially the knowledge ever acquired, was slow relatively. The other aspects continued deteriorating in all stages of VD.

Key words: dementia, vascular, neuropsychology