中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
3期
160-164
,共5页
廖晓艳%山川みゃえ%釜江和惠%周藤俊智%牧本清子
廖曉豔%山川みゃえ%釜江和惠%週籐俊智%牧本清子
료효염%산천みゃえ%부강화혜%주등준지%목본청자
阿尔茨海默病%额颞痴呆%徘徊行为%落日现象
阿爾茨海默病%額顳癡呆%徘佪行為%落日現象
아이자해묵병%액섭치태%배회행위%락일현상
Alzheimer disease%Frontotemporal dementia%Wandering behavior%Sundowning
目的 探索阿尔茨海默病和额颞叶痴呆患者徘徊行为的落日现象,并比较该现象在两痴呆亚型之间的差异.方法 利用电子示踪监测系统对2008年9月至2009年9月入住大阪浅香山医院,符合纳入标准的27例阿尔茨海默病及7例额颞叶痴呆患者进行连续30 d的步行活动监测,分析并比较两者24h标准化活动水平的变化.结果 经Huynh-Feldt Epsilon(H-F)校正后的重复测量方差分析显示两组24h标准化活动水平差异无统计学意义(F=3.74,P=0.06),分组因素与时间因素无交互效应(F=1.42,P＞0.05),两组间标准化活动水平变化趋势不服从第17次项曲线(F=5.24,P＜0.05)和第9次项曲线(F=4.26,P=0.05).两组标准化活动水平均逐渐增高,阿尔茨海默病组在18:00达到最高点,额颢叶痴呆组则在19:00达到最高点,Bonferroni法多重比较显示阿尔茨海默病组在5:00 ～7:00的标准化活动水平较额颞叶痴呆组高(分别为0.75±0.08比0.35±0.16,F =4.91；1.13±0.13比0.49±0.26,F=5.06；1.24±0.15比0.56±0.28,F=4.47；P＜0.05),而在16:00则较低(1.65±0.11比2.22±0.22,P＜0.05).圆形分布x2检验显示额颞叶痴呆组活动峰值时间较阿尔茨海默病组延迟(14:12±5:12比15:47±4:19,x2=87.31,P＜0.01).结论 徘徊行为的落日现象在阿尔茨海默病及额颞叶痴呆中均有出现,但两者徘徊行为时间趋势不尽相同.与额颞叶痴呆患者相比,阿尔茨海默病患者徘徊行为时相较长,且峰值时间较早.
目的 探索阿爾茨海默病和額顳葉癡呆患者徘佪行為的落日現象,併比較該現象在兩癡呆亞型之間的差異.方法 利用電子示蹤鑑測繫統對2008年9月至2009年9月入住大阪淺香山醫院,符閤納入標準的27例阿爾茨海默病及7例額顳葉癡呆患者進行連續30 d的步行活動鑑測,分析併比較兩者24h標準化活動水平的變化.結果 經Huynh-Feldt Epsilon(H-F)校正後的重複測量方差分析顯示兩組24h標準化活動水平差異無統計學意義(F=3.74,P=0.06),分組因素與時間因素無交互效應(F=1.42,P＞0.05),兩組間標準化活動水平變化趨勢不服從第17次項麯線(F=5.24,P＜0.05)和第9次項麯線(F=4.26,P=0.05).兩組標準化活動水平均逐漸增高,阿爾茨海默病組在18:00達到最高點,額顥葉癡呆組則在19:00達到最高點,Bonferroni法多重比較顯示阿爾茨海默病組在5:00 ～7:00的標準化活動水平較額顳葉癡呆組高(分彆為0.75±0.08比0.35±0.16,F =4.91；1.13±0.13比0.49±0.26,F=5.06；1.24±0.15比0.56±0.28,F=4.47；P＜0.05),而在16:00則較低(1.65±0.11比2.22±0.22,P＜0.05).圓形分佈x2檢驗顯示額顳葉癡呆組活動峰值時間較阿爾茨海默病組延遲(14:12±5:12比15:47±4:19,x2=87.31,P＜0.01).結論 徘佪行為的落日現象在阿爾茨海默病及額顳葉癡呆中均有齣現,但兩者徘佪行為時間趨勢不儘相同.與額顳葉癡呆患者相比,阿爾茨海默病患者徘佪行為時相較長,且峰值時間較早.
목적 탐색아이자해묵병화액섭협치태환자배회행위적락일현상,병비교해현상재량치태아형지간적차이.방법 이용전자시종감측계통대2008년9월지2009년9월입주대판천향산의원,부합납입표준적27례아이자해묵병급7례액섭협치태환자진행련속30 d적보행활동감측,분석병비교량자24h표준화활동수평적변화.결과 경Huynh-Feldt Epsilon(H-F)교정후적중복측량방차분석현시량조24h표준화활동수평차이무통계학의의(F=3.74,P=0.06),분조인소여시간인소무교호효응(F=1.42,P＞0.05),량조간표준화활동수평변화추세불복종제17차항곡선(F=5.24,P＜0.05)화제9차항곡선(F=4.26,P=0.05).량조표준화활동수평균축점증고,아이자해묵병조재18:00체도최고점,액호협치태조칙재19:00체도최고점,Bonferroni법다중비교현시아이자해묵병조재5:00 ～7:00적표준화활동수평교액섭협치태조고(분별위0.75±0.08비0.35±0.16,F =4.91；1.13±0.13비0.49±0.26,F=5.06；1.24±0.15비0.56±0.28,F=4.47；P＜0.05),이재16:00칙교저(1.65±0.11비2.22±0.22,P＜0.05).원형분포x2검험현시액섭협치태조활동봉치시간교아이자해묵병조연지(14:12±5:12비15:47±4:19,x2=87.31,P＜0.01).결론 배회행위적락일현상재아이자해묵병급액섭협치태중균유출현,단량자배회행위시간추세불진상동.여액섭협치태환자상비,아이자해묵병환자배회행위시상교장,차봉치시간교조.
Objectives To delineate the difference in sundowning of wandering behavior between patient with Alzheimer Disease (AD) and frontotemporal dementia (FTD).Methods The study was conducted in a dementia care unit at A hospital in Osaka,Japan from September 2008 to September 2009.Twenty-four-hour movements of 27 ambulatory inpatients with AD and 7 with FTD were coded consecutively by the IC tag monitoring system.Results Repeated measures ANOVA after the adjustment of Huynh-Feldt Epsilon (H-F) showed no significant difference in 24 h standardized activity level between two groups ( F =3.74,P =0.06),and there was no interaction between diagnosis and time ( F =1.42,P ＞0.05 ).The standardized activity levels gradually increased from late afternoon to evening and then reached the highest point at 18:00 in AD group and 19:00 in FTD group.Test of within-subjects contrasts for order 17 was significant ( F =5.24,P ＜ 0.05 ) and for order 9 was a tendency of significant ( F =4.26 ; P =0.05 ) between two groups.AD group was significant greater active at 5:00,6:00 and 7:00 ( 0.75 ± 0.08 vs 0.35 ±0.16,F=4.91 ; 1.13 ±0.13 vs 0.49 ±0.26,F=5.06; 1.24 ±0.15 vs 0.56 ±0.28,F =4.47 respectively,P ＜ 0.05),and less active at 16:00 ( 1.65 ± 0.11 vs 2.22 ± 0.22,P ＜ 0.05 ) comparing to FTD group by Bonferroni's multiple comparison test.Meanwhile,the time of peak value of hourly distance moved per day (PV-time) was delayed in FTD group comparing to AD by circular x2 test (14:12 ± 5:12 vs 15:47 ± 4:19,x2 =87.31,P ＜ 0.01 ).Conclusions The study suggests great possibility of sundowning of wandering behavior in both two subtypes with different temporal pattern of wandering behavior.Comparing to FTD patients,AD patients showed an advanced PV- time and prolonged active phase.
