中国大陆血管性痴呆患者的神经精神症状
Neuropsychiatric symptoms in patients with vascular dementia in mainland China.
作者信息
Jin Yan-Ling, Zhang Hong, Gao Yong-Zhe, Shu Min, Xu Yan, Liu Xi, Zhang Sheng-Ming, Zou Chao-Yu, Cao Jing, Xiong Rong-Hong
机构信息
Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Teaching and research section of Neuropsychiatry, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Clinical medical research center for dementia and cognitive impairment in Hubei province, Wuhan 430071, China.
出版信息
Transl Neurosci. 2015 Aug 21;6(1):157-161. doi: 10.1515/tnsci-2015-0015. eCollection 2015.
BACKGROUND
Neuropsychiatric deficits can induce marked disability in patients with dementia and increase caregiver distress. Several studies have found that neuropsychiatric symptoms are common both in patients with Alzheimer's disease (AD) and patients with vascular dementia (VaD). However, there are few studies of the neuropsychiatric disturbances in large clinical samples of patients with mixed (cortical - subcortical) VaD from mainland China. This study aimed to investigate the neuropsychiatric symptoms in VaD patients in mainland China.
METHODS
Eighty patients with mixed VaD for over 6 months duration, and their caregivers (VaD group), were recruited for interview in Zhongnan Hospital of Wuhan University, from June 2010 to June 2012. Eighty age- and sex-matched normal volunteers (control group) were interviewed at the same time. The Mini Mental State Examination (MMSE) and the Neuropsychiatric Inventory (NPI) were administered to the VaD patients, their caregivers, and normal volunteers. Group differences were analyzed using the unpaired t-test.
RESULTS
The total mean scores of the NPI in the VaD group were higher than in the control group ( < 0.01). The subscale scores of NPI, including delusions, hallucinations, depression, apathy, irritability, agitation, aberrant motor behavior, and change in appetite were significantly higher in the VaD group than in the control group ( < 0.05-0.01). Compared with the mild VaD subgroup, the NPI subscale scores of apathy, irritability and total scores were significantly higher in the moderate VaD subgroup ( < 0.05-0.01); the NPI subscale scores of anxiety, apathy, irritability, and total scores were significantly higher in the severe VaD subgroup ( < 0.01). Compared with the moderate VaD subgroup, the NPI subscale scores of anxiety and apathy were significantly higher in the severe VaD subgroup ( < 0.05-0.01).
CONCLUSIONS
Neuropsychiatric symptoms, such as hallucination, anxiety, apathy, irritability and aberrant action behavior, are common in patients with mixed VaD from mainland China; anxiety and apathy were more pronounced in the subgroup of severe VaD patients.
背景
神经精神缺陷可导致痴呆患者出现明显残疾，并增加照料者的痛苦。多项研究发现，神经精神症状在阿尔茨海默病（AD）患者和血管性痴呆（VaD）患者中均很常见。然而，针对中国大陆大量混合性（皮质 - 皮质下）VaD患者临床样本的神经精神障碍研究较少。本研究旨在调查中国大陆VaD患者的神经精神症状。
方法
2010年6月至2012年6月，在武汉大学中南医院招募了80例病程超过6个月的混合性VaD患者及其照料者（VaD组）进行访谈。同时对80名年龄和性别匹配的正常志愿者（对照组）进行访谈。对VaD患者、其照料者和正常志愿者进行简易精神状态检查表（MMSE）和神经精神科问卷（NPI）评估。采用非配对t检验分析组间差异。
结果
VaD组NPI的总平均分高于对照组（<0.01）。VaD组NPI的分量表得分，包括妄想、幻觉、抑郁、淡漠、易激惹、激越、异常运动行为和食欲改变，均显著高于对照组（<0.05 - 0.01）。与轻度VaD亚组相比，中度VaD亚组的淡漠、易激惹分量表得分及总分显著更高（<0.05 - 0.01）；重度VaD亚组的焦虑、淡漠、易激惹分量表得分及总分显著更高（<0.01）。与中度VaD亚组相比，重度VaD亚组的焦虑和淡漠分量表得分显著更高（<0.05 - 0.01）。
结论
幻觉、焦虑、淡漠、易激惹和异常行为等神经精神症状在中国大陆混合性VaD患者中很常见；重度VaD患者亚组中的焦虑和淡漠更为明显。
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