【摘要】 目的 探讨轻度认知功能障碍的心理学特点及其危险因素。 方法 由神经专科医生采集2009年9-12月在神经内科门诊就诊患者106例的临床资料，进行简易智能量表（MMSE）、听觉词语测验（AVLT）、画钟测验（CDT）、日常生活功能量表（ADL）、Hamilton 抑郁量表（HDRS）及临床痴呆评定量表（CDR）等神经心理测试。根据检查结果分为MCI组与对照组。 结果 MCI组受教育年限低于对照组（Plt;0.05），高血压病、糖尿病、脑卒中史高于对照组（Plt;0.05）。Logistic多因素回归分析显示受教育年限和高血压病史与MCI密切相关。MCI组MMSE总分、CDT得分、AVLT即刻记忆、延迟记忆及长时延迟再认显著低于对照组，ADL评分及HDRS评分高于对照组（Plt;0.05）。 结论 高血压病是MCI的危险因素，较高的受教育年限是MCI的保护因素。MCI患者在多个神经心理学领域受损。【Abstract】 Objective To investigate the neuropsychological characteristics of mild cognitive impairment (MCI) and its risk factors. Methods The clinical data of 106 patients in our neurologic department from september to December 2009, were collected by neurologists,and tested them by Chinese version of the mini-mental state examination (MMSE) , auditory verbal learning test (AVLT) , clock drawing test (CDT)、activities of daily living (ADL)、Hamilton depression rating scale (HDRS) and clinical dementia rating scale (CDR). All subjects were divided into MCI patients group and the control group. Results Educational level was significantly lower and hypertension, diabetes mellitus and stroke history were significantly more in patients with MCI than the control. The factors associated with MCI in logistic regression analysis were lower educational level and hypertension. The scores of MMSE、CDT and AVLT of MCI were significantly lower than those of the control, and the scores of ADL and HDRS were significantly higher than those of the control (Plt;0.05). Conclusion Hypertension is the risk factor and high educational level is the protective factor for MCI. MCI patients are impaired in multiple neuropsychological domains.
【摘要】 目的 通过比较遗忘型轻度认知障碍（amnestic mild cognitive impairment，aMCI）和血管性认知障碍非痴呆型（vascular cognitive impairment-no dementia，VCI-ND）患者及正常老年人群在简易智能精神状态检查量表（mini mental state examination，MMSE）、听觉词语学习测验（auditory verbal learning test，AVLT）、画钟试验（clock drawing test，CDT）及临床痴呆评定量表（clinical dementia rating scales，CDR）中的表现，进一步分析aMCI和VCI-ND在认知损害方面的不同特点。 方法 选取首都医科大学宣武医院神经内科门诊收治aMCI患者23例及VCI-ND患者27例（CDR＝0.5分），同时选取40名正常老年人（CDR=0分）作为对照组。每位受试者均进行MMSE、AVLT、CDT及CDR等神经心理学量表测查，分析以上3组被试各项神经心理学测查得分之间的差异。 结果 各组受试者的年龄、性别及受教育程度差异无统计学意义（Pgt;0.05），具有可比性。aMCI和VCI-ND组在MMSE、CDT、即刻记忆、延迟记忆及延迟再认检测中的平均值均低于对照组，且差异均具有统计学意义（Plt;0.05）。aMCI和VCI-ND两组除延迟再认检测外，其余各项测查的平均分均无统计学意义（Pgt;0.05）。在延迟再认检测中，aMCI组（6.65±4.00）较VCI-ND组（8.67±2.76）再认词语数量少，两组延迟再认的得分均低于对照组（12.83±1.77），差异有统计学意义（Plt;0.05）。 结论 aMCI和VCI-ND在记忆力、执行能力和信息处理能力方面较正常老年人均有所损害。由于aMCI和VCI-ND不同的病理改变，导致患者存在不同类型的记忆储存和提取机制。【Abstract】 Objective To investigate the different patterns of cognitive impairment in patients with amnestic mild cognitive impairment (amci), vascular cognitive impairment-no dementia (VCI-ND) and normal elder people. Methods A total of 23 patients with aMCI and 27 patients with VCI-ND (CDR＝0.5) and another 40 healthy elder people (CDR=0) were selected. Each individual underwent the neuropsychological tests, including mini mental state examination (MMSE), auditory verbal learning test (AVLT), clock drawing test (CDT), clinical dementia rating scales (CDR) and hamilton rating scale for depression (HAMD). The differences between the three groups were analyzed. Results The differences in age, sexes, and the education background among the three groups were not significant (Pgt;0.05) which meant comparability. The mean scores of MMSE, CDT, instant memory and delayed awareness in aMCI and VIC-ND group were much lower than that in the control group (Plt;0.05). The differences in all the test items except for delayed awareness between aMCI group and VCI-ND groups were not significant (Pgt;0.05). However, in the recall recognition test, these three groups had significant differences: the score in patients with aMCI (6.65±4.00) was much lower than that in patients with VCI-ND (8.67±2.76; Plt;0.05), and the scores of the two groups were both lower than that in the normal aging group (12.83±1.77; Plt;0.05). Conclusion Compared with normal elder people, the cognition of aMCI and VCI-ND patients is impaired severely. The memory tests suggeste that compared with aMCI patients, VCI-ND patients may have different neuropathological changes leading to different mechanism of memory encoding and retrieval.