本文選題：皮質(zhì)下缺血性血管病 + 輕度認知功能損害��； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的探討皮質(zhì)下缺血性血管�。╯ubcortical ischemic vascular disease, SIVD）患者神經(jīng)精神癥狀（neuropsychiatric symptoms,NPS）的臨床特征。 方法采用中文版神經(jīng)精神科問卷（Chinese version of the neuropsychiatricinventory,CNPI）對50例正常健康老年人（normal controls,NC）、101例SIVD患者，其中51例皮質(zhì)下血管性輕度認知功能損害（subcortical vascular mild cognitiveimpairment, SVMCI）及50例皮質(zhì)下血管性癡呆患者（subcortical vascular dementia,SVaD）進行評定，比較各組間NPS的特征以及SVMCI和SVaD組之間NPS的發(fā)生率。 結(jié)果3組間CNPI總分有顯著性差異，SVMCI組CNPI得分顯著高于NC組且低于SVaD組，差異有統(tǒng)計學(xué)意義（P0.01）。SVaD組與NC組比較在激越、心境惡劣、焦慮、情感淡漠、易激惹、睡眠行為及進食障礙等癥狀得分方面差異有統(tǒng)計學(xué)意義（P0.05）；SVMCI組與NC組比較在激越、情感淡漠、易激惹癥狀得分方面差異有統(tǒng)計學(xué)意義（P0.05）。從NPS發(fā)生率來看，SVaD組情感淡漠、睡眠行為、心境惡劣、進食障礙、異常行為發(fā)生率均顯著高于SVMCI組，且差異有統(tǒng)計學(xué)意義（χ2=10.99，P=0.001; χ2=8.72. P=0.003; χ2=4.32，P=0.037; χ2=4.0，P=0.045;χ2=5.66.P=0.017）。 結(jié)論NPS是SIVD患者常見的臨床癥狀；情感淡漠等癥狀是SIVD患者特征性的NPS表現(xiàn)，且隨著認知損害的加重而愈加明顯。 目的探討皮質(zhì)下缺血性血管病(subcortical ischemic vascular disease, SIVD)患者皮質(zhì)下缺血性損害（subcortical ischemic lesions, SIL）與神經(jīng)精神癥狀（neuropsychiatricsymptoms, NPS）之間的相關(guān)性。 方法選擇144例SIVD患者，，其中認知功能正常59例，輕度認知損害患者49例，癡呆患者36例，使用MRI半定量量表評價SIL情況，頭顱MRI線性腦萎縮測量法測量腦萎縮指標；采用簡明精神狀態(tài)量表（Mini-mental StateExamination,MMSE）評價總體認知功能，神經(jīng)精神科問卷中文版（Chinese versionof the neuropsychiatric inventory, CNPI）評價NPS，二元Logistic回歸分析SIL與NPS間的相關(guān)性。 結(jié)果在控制性別、年齡、總體認知功能、腦萎縮等情況下，側(cè)腦室旁白質(zhì)病變與焦慮密切相關(guān)（OR2.21,95%CI1.13-4.32），腦室旁白質(zhì)病變總分與睡眠行為異常相關(guān)（OR1.41,95%CI1.02-1.96）；基底節(jié)區(qū)白質(zhì)病變總分與情感淡漠顯著相關(guān)（OR1.23,95%CI1.07-1.41）；基底節(jié)區(qū)腔隙性梗死與脫抑制密切相關(guān)（OR3.37,95%CI1.06-10.71）；顳葉白質(zhì)病變與欣快顯著相關(guān)（OR1.73,95%CI1.08-2.77）。 結(jié)論SIVD患者SIL與NPS密切相關(guān)，特定部位的皮質(zhì)下?lián)p害可導(dǎo)致相應(yīng)NPS的發(fā)生。
[Abstract]:Objective to investigate the clinical features of neuropsychiatric symptoms in patients with subcortical ischemic vascular disease, SIVD. Methods the Chinese version of the neuropsychiatric inventory (CNPI) was used in the study of 50 healthy elderly patients with normal control normal NCU, 101 patients with SIVD. Among them, 51 cases of subcortical vascular mild cognitiveimpairment, with mild cognitive impairment and 50 cases of subcortical vascular dementia (SVaD) were evaluated. The characteristics of NPS and the incidence rate of SVMCI and SVaD were compared. Results there was significant difference in the total scores of CNPI between the three groups. The CNPI score of SVMCI group was significantly higher than that of NC group and lower than that of SVaD group. The difference was statistically significant compared with NC group. There were significant differences in the scores of sleep behavior and eating disorders between SVMCI group and NC group in terms of agitation, apathy and irritability (P 0.05). The incidence of NPS in SVaD group was significantly higher than that in SVMCI group (蠂 2 + 10.99% P0. 001; 蠂 2 + 8. 72 2). The incidence of emotional indifference, sleep behavior, bad mood, eating disorder and abnormal behavior in SVaD group were significantly higher than those in SVMCI group. P0. 003; 蠂 2: 4. 32, P0. 037; 蠂 2, 0. 0, P0. 045; 蠂 2, 5. 66. P0. 017. Conclusion NPS is a common clinical symptom in patients with SIVD, and emotional apathy is a characteristic manifestation of NPS in patients with SIVD, and it becomes more and more obvious with the aggravation of cognitive impairment. Objective to investigate the relationship between subcortical ischemic lesions (sil) and neuropsychedelic disorders (NPSs) in subcortical ischemic vascular disease, patients. Methods 144 patients with SIVD were selected, including 59 patients with normal cognitive function, 49 patients with mild cognitive impairment and 36 patients with dementia. The sil was evaluated with MRI semi-quantitative scale. Brain atrophy was measured by linear brain MRI. The total cognitive function was evaluated by Mini-Mental Mental examination scale (MMSE), the Chinese versionof the neuropsychiatric inventory, CNPI was evaluated by Chinese Psychiatry questionnaire, and the correlation between sil and NPS was analyzed by binary Logistic regression analysis. Results under the condition of controlling sex, age, total cognitive function and brain atrophy, there was a close correlation between paraventricular white matter lesion and anxiety. The total score of ventricular white matter lesion was correlated with sleep behavior abnormality. The total score of white matter lesions in basal ganglia was significantly correlated with affective apathy (OR 1.2395 CI 1.07-1.41); basal ganglia lacunar infarction was closely related to depressor activity; OR3.37 ~ 95CI1.06-10.71; and temporal white matter lesion was significantly correlated with OR 1.7395CI1.08-2.77. Conclusion sil is closely related to NPS in patients with SIVD, and subcortical damage in specific sites may lead to the occurrence of NPS.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

【共引文獻】

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本文編號：2031990