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非脑血管性快速进展性认知功能减退的谱系:一项为期2年的回顾性研究。

Spectrum of noncerebrovascular rapidly progressive cognitive deterioration: a 2-year retrospective study.

作者信息

Zhang Yun, Gao Ting, Tao Qing-Qing

机构信息

Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Clin Interv Aging. 2017 Oct 9;12:1655-1659. doi: 10.2147/CIA.S144821. eCollection 2017.

Abstract

PURPOSE

The number of cognitive deterioration patients has been steadily increasing as the population ages in China. Patients with cognitive deterioration demonstrated diverse patterns, often making the diagnosis difficult, especially in rapidly progressive cognitive deterioration (RPCD) patients. The purpose of this study was to exhibit the disease spectrum and frequency of noncerebrovascular RPCD in patients from a medical college hospital of southeastern China.

MATERIALS AND METHODS

We performed a 2-year retrospective cohort study including 310 RPCD patients who had been admitted to the Department of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, from January 1, 2015 to December 31, 2016. RPCD patients' information on epidemiologic data and clinical aspects were collected. All the data were analyzed using SPSS.

RESULTS

Of a total of 310 patients hospitalized for RPCD diagnosis, mean age of onset was 55.92±18.89 years. The most common cause of RPCD was viral encephalitis, accounting for 21.9% (68) of the cases, followed by Alzheimer's disease and autoimmune encephalitis, accounting for 14.5% (45) and 9.0% (28) of the cases, respectively. Creutzfeldt-Jakob disease accounted for 7.1% (22) of the cases. Patients in the secondary RPCD group tended to be younger than those in the primary RPCD group and experienced a more rapid progression course.

CONCLUSION

Our study suggests that the most common causes of RPCD are secondary neurological diseases and most of them are potentially reversible under appropriate treatment of the underlying disease. The spectrum and frequency of RPCD in our cohort is comparable with a previous study performed in the European population.

摘要

目的

随着中国人口老龄化,认知功能减退患者数量一直在稳步增加。认知功能减退患者表现出多种模式,常常使诊断变得困难,尤其是在快速进展性认知功能减退(RPCD)患者中。本研究的目的是展示中国东南部一所医学院校附属医院中RPCD患者的疾病谱及非脑血管性RPCD的发生率。

材料与方法

我们进行了一项为期2年的回顾性队列研究,纳入了2015年1月1日至2016年12月31日期间在浙江大学医学院附属第二医院神经内科住院的310例RPCD患者。收集了RPCD患者的流行病学数据和临床方面的信息。所有数据均使用SPSS进行分析。

结果

在总共310例因RPCD诊断住院的患者中,平均发病年龄为55.92±18.89岁。RPCD最常见的病因是病毒性脑炎,占病例的21.9%(68例),其次是阿尔茨海默病和自身免疫性脑炎,分别占病例的14.5%(45例)和9.0%(28例)。克雅氏病占病例的7.1%(22例)。继发性RPCD组的患者往往比原发性RPCD组的患者更年轻,且病程进展更快。

结论

我们的研究表明,RPCD最常见的病因是继发性神经系统疾病,在对基础疾病进行适当治疗的情况下,其中大多数可能是可逆的。我们队列中RPCD的疾病谱和发生率与之前在欧洲人群中进行的一项研究相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/155b/5640397/cf7a1080958d/cia-12-1655Fig1.jpg

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