中重度阿尔茨海默病患者神经心理学症状探究.docVIP

中重度阿尔茨海默病患者神经心理学症状探究 　 作者：麻小莉，董乐丹，付晔，夏叶子，何金彩 【摘要】 目的 ：用神经心理学的检测工具对中度和重度阿尔茨海默病(Alzheimers diease，AD)患者进行测试，比较不同严重程度AD患者的认知和精神行为障碍的特点。方法：采用MMSE、AVLT、ADAS-cog对中度和重度AD患者进行认知功能测试，用ADL、NPI对其非认知功能进行评定。结果：随病程的延长，AD患者的病情加重。重度AD患者的MMSE、AVLT、ADAS-cog、ADL、NPI得分均较中度AD患者明显差。在MMSE测试中，两者在时间定向、计算、记忆力、语言、运用和视空间技能五个亚项上差异均有显著性(Plt;0.05)。在AVLT测试中，两者的即刻记忆和延迟记忆差异均存在显著性(Plt;0.05)。在ADAS-cog测试中，两者在指令的回忆、单词回忆、找词困难和语言理解四个亚项上差异有显著性(Plt;0.05)。在ADL中，躯体生活自理方面，两者差异无显著性(Pgt;0.05);在工具性日常生活活动方面，两者差异有显著性(Plt;0.05)。在神经精神症状上，重度AD患者在淡漠、异常行为方面发生率均较高。结论：总体来说，AD患者的病情越重，认知功能和生活自理能力越差，精神症状越重，但不同症状差异不同。 【关键词】 阿尔茨海默病;神经心理学;认知功能;非认知功能 　Abstract: Objective: Use neuropsychological testing tool to detect moderate and severe stateAlzheimers patients，for comparing the differences of cognitive and mental-behavioural disor-dersbetween them. Methods: Use MMSE，VLT and ADAS-cog scales to test cognitive function， use ADL andNPI scales to test non-cognitive function. Results: With the course of disease extending，theseverity growing. The performence of ADAS-cog，AVLT，MMSE，ADL and NPI in severe AD patients waspoorer than that in the moderate ones. In MMSE test，every performance of the five items insevere-state AD patients was lower than that in the moderate-state AD ones. The difference wassignificant (P lt;0.05). In AVLT tests，the difference of immediate memory and delayed memory betweenthe two states of AD was significant. In ADAS-cog test，the performance of recall memory forinstructions，word memory，difficulty in finding words or language comprehension was poor insevere-state AD patients than those in the moderate-state AD ones. The difference was significant(P lt;0.05). In ADL scale，body self-care had no significant difference(P gt;0.05). Instrumentalactiities of daily living had significant difference (P lt;0.05). In severe-state AD patients therewas higher incidence in abnormal behavior and indifference performance. Conclusion: Overall，in AD patients with the severity growing，the cognition function and self-care