Leel-Ossy L
Vaszary Kolos Kórház, Esztergom.
Orv Hetil. 1995 Jul 30;136(31):1651-7.
The exact diagnosis of dementias proved to be very important in the increasing research activity of Alzheimer's dementia. The National Stroke Programme stresses the significance of the study of the other--relatively frequent--form of dementia i.e. the much more intensive research of the vascular dementia. This study involved 287 clinical and pathological cases of vascular dementias. The 195 clinical cases agreed with the probable and possible criteria of vascular dementia. The pathological examinations of 92 cases proved the definite category of diagnosis. Four groups of vascular dementias should be differentiated among the pathologically verified as well as in the clinically selected cases which were considered of practical--prognostic and therapeutic importance. The Hachinski's ischemic scale appeared to be reliable approximately in 90 percent in the differential diagnosis between the vascular and Alzheimer dementias especially in the multi-infarct group. The urgent diagnosis and adequate admission of the demented patients should be the task of the house physicians beside the therapeutical recommendations, mental training and the rehabilitative activity emphasized in the report. Furthermore the postgraduate education of house physician considering the dementias as well as the popular publications on dementias for the patient's relatives should also be necessary associated with good organization and with financial support.
在阿尔茨海默病痴呆症研究活动日益增多的情况下,痴呆症的准确诊断被证明非常重要。国家中风计划强调了对另一种相对常见的痴呆症形式进行研究的重要性,即对血管性痴呆症进行更深入的研究。这项研究涉及287例血管性痴呆症的临床和病理病例。195例临床病例符合血管性痴呆症的可能和疑似标准。92例病例的病理检查证实了明确的诊断类别。在经病理证实以及临床选定的病例中,应区分出四组血管性痴呆症,这在实际预后和治疗方面具有重要意义。哈金斯基缺血量表在血管性痴呆症和阿尔茨海默病痴呆症的鉴别诊断中,尤其是在多发梗死组中,约90%的情况下似乎是可靠的。除了报告中强调的治疗建议、心理训练和康复活动外,家庭医生的任务还应包括对痴呆患者进行紧急诊断和适当收治。此外,考虑到痴呆症对家庭医生进行研究生教育以及为患者亲属提供有关痴呆症的通俗读物,也应与良好的组织和资金支持相结合。