Risse S C, Raskind M A, Nochlin D, Sumi S M, Lampe T H, Bird T D, Cubberley L, Peskind E R
Psychiatry Service, American Lake VA Medical Center, Tacoma, WA 98493.
Am J Psychiatry. 1990 Feb;147(2):168-72. doi: 10.1176/ajp.147.2.168.
To assess prospectively the accuracy of standard antemortem clinical diagnostic criteria for Alzheimer's disease, post-mortem examinations were performed on 25 patients who had met DSM-III criteria for primary degenerative dementia and National Institute of Neurological and Communicative Disorders and Stroke criteria for probable Alzheimer's disease. Seventeen patients (68%) met neuropathological criteria for Alzheimer's disease. Two presenile-onset patients had diffuse neocortical senile plaques of insufficient number for definite Alzheimer's disease. Six patients had non-Alzheimer's disease diagnoses. Five of these six had presenile-onset dementia. These results suggest caution in the antemortem diagnosis of Alzheimer's disease in presenile-onset dementia.
为前瞻性评估阿尔茨海默病标准生前临床诊断标准的准确性,对25例符合原发性退行性痴呆的DSM-III标准以及可能的阿尔茨海默病的国立神经疾病和中风研究所标准的患者进行了尸检。17例患者(68%)符合阿尔茨海默病的神经病理学标准。2例早发性患者有弥漫性新皮质老年斑,但数量不足以确诊为阿尔茨海默病。6例患者诊断为非阿尔茨海默病。这6例中的5例患有早发性痴呆。这些结果提示,对于早发性痴呆患者的阿尔茨海默病生前诊断需谨慎。