CAJ | 학술논문

目的了解血管性痴呆(VaD)患者的精神行为学症状特点及与认知障碍、年龄、受教育程度等因素的相关性,探讨神经精神科问卷(NPI)中不同因子之间的内在联系. 方法采用NPI和简易智能状态检查量表(MMSE),分别评价120例VaD患者和61例健康老年人的精神行为学症状. 结果 VaD组患者NPI量表中的妄想、幻觉、激越、抑郁/心境恶劣、淡漠、易激惹、异常行为、食欲和饮食障碍等8个症状得分均明显高于正常对照组,差异有统计学意义(P＜0.05),其中得分最高的3个症状依次为抑郁/心境恶劣、情感淡漠、易激惹；其中幻觉、情感淡漠、异常行为等因子与认知障碍程度高度相关；异常行为与年龄、受教育程度均相关；同时对NPI各因子进行分析,获得了3个亚综合征,分别代表精神病性、情感异常和失控制行为. 结论 VaD患者普遍存在精神行为学症状,其症状的出现及严重程度与认知障碍、年龄、受教育程度有不同程度的相关性,各亚综合征中的子因子可能存在共同的病理生理基础.
목적 료해혈관성치태(VaD)환자적정신행위학증상특점급여인지장애、년령、수교육정도등인소적상관성,탐토신경정신과문권(NPI)중불동인자지간적내재련계. 방법 채용NPI화간역지능상태검사량표(MMSE),분별평개120례VaD환자화61례건강노년인적정신행위학증상. 결과 VaD조환자NPI량표중적망상、환각、격월、억욱/심경악렬、담막、역격야、이상행위、식욕화음식장애등8개증상득분균명현고우정상대조조,차이유통계학의의(P＜0.05),기중득분최고적3개증상의차위억욱/심경악렬、정감담막、역격야；기중환각、정감담막、이상행위등인자여인지장애정도고도상관；이상행위여년령、수교육정도균상관；동시대NPI각인자진행분석,획득료3개아종합정,분별대표정신병성、정감이상화실공제행위. 결론 VaD환자보편존재정신행위학증상,기증상적출현급엄중정도여인지장애、년령、수교육정도유불동정도적상관성,각아종합정중적자인자가능존재공동적병리생리기출.
Objective To analyze the behavioral and psychological symptoms in patients with vascular dementia (VaD),investigate the relationship between behavioral and psychological symptoms and such correlative factors as cognitive disturbance,age,education level of the patients,and explore the internal relations among Neuropsychiatric Inventory (NPI) items. Methods NPI and Mini-Mental State Examination (MMSE) were introduced to assess the behavioral and psychological symptoms in 120patients with VaD and 61 healthy elders (control group). Results The VaD patient group had significantly higher scores in 8 items,including delusion,hallucination,agitation,dysphoria,apathy,irritability,aberrant motor and appetite/eating changes in the NPI list,as compared with the control group (P＜0.05),with the points ranked from the highest by dysphoria,apathy and irritability.Among the 8 items in the NPI list, delusion, apathy and aberrant motor were significantly correlated with cognitive disturbance; and aberrant motor was correlated with age and education level.Besides that,NPI factor analysis showed that 3 behavioral sub-syndromes,psychosis,mood disorder and behavioral disturbance,exited. Conclusion Behavioral and psychological symptoms were common in VaD patients,and the frequency and severity of appearing of behavioral and psychological symptoms were correlated with cognitive disturbance,age,and education level of different degrees; in addition,each sub-syndrome may have common pathophysiologic mechanism.