CAJ | 학술논문

目的探讨遗忘型轻度认知功能损害(aMCI)的转归及其认知特征的变化.方法横断面病例-对照和队列研究.采用多维度神经心理测试评估109例aMCI患者和104例正常对照者的神经认知功能.结果与正常对照组相比,aMCI组的各项神经认知功能基线测试成绩均显著下降(均P＜0.01),尤以反映情节记忆的听觉词语记忆测试(AVMT)的20min延迟回忆受损最明显[aMCI组(2.50±1.48)分,正常对照组(7.85±1.59)分,Z=-12.697,P＜0.01];随访期间69例aMCI患者有15例转变为AD,转化率22%,而正常组无转变为AD者;随访期间aMCI组患者的AVMT、CDT及MMSE测试成绩的减分率[分别为(3.77±60.83)%,(6.89±28.24)%,(6.13±16.89)%]低于正常对照组[分别为(-10.75±27.46)%,(-5.23±14.05)%,(-1.11±8.26)%],差异具有显著性(均P＜0.05);将aMCI组分为认知功能稳定组及转变为AD组,比较2组之间神经认知功能基线测试成绩,差异有统计学意义的测验有AVMT、CFT、TMT-A、TMT-B、SDMT、CDT及MMSE;进一步比较2组之间测试成绩的减分率,aMCI组中转变为AD者AVMT、CFT、DST、VFT、SDMT、MMSE显著下降,差异具有显著性(均P＜0.05).结论 aMCI是AD的前驱期;aMCI患者存在明显的情节记忆减退;神经心理测试有助于预测aMCI是否发展为AD.
목적 탐토유망형경도인지공능손해(aMCI)적전귀급기인지특정적변화.방법 횡단면병례-대조화대렬연구.채용다유도신경심리측시평고109례aMCI환자화104례정상대조자적신경인지공능.결과 여정상대조조상비,aMCI조적각항신경인지공능기선측시성적균현저하강(균P＜0.01),우이반영정절기억적은각사어기억측시(AVMT)적20min연지회억수손최명현[aMCI조(2.50±1.48)분,정상대조조(7.85±1.59)분,Z=-12.697,P＜0.01];수방기간69례aMCI환자유15례전변위AD,전화솔22%,이정상조무전변위AD자;수방기간aMCI조환자적AVMT、CDT급MMSE측시성적적감분솔[분별위(3.77±60.83)%,(6.89±28.24)%,(6.13±16.89)%]저우정상대조조[분별위(-10.75±27.46)%,(-5.23±14.05)%,(-1.11±8.26)%],차이구유현저성(균P＜0.05);장aMCI조분위인지공능은정조급전변위AD조,비교2조지간신경인지공능기선측시성적,차이유통계학의의적측험유AVMT、CFT、TMT-A、TMT-B、SDMT、CDT급MMSE;진일보비교2조지간측시성적적감분솔,aMCI조중전변위AD자AVMT、CFT、DST、VFT、SDMT、MMSE현저하강,차이구유현저성(균P＜0.05).결론 aMCI시AD적전구기;aMCI환자존재명현적정절기억감퇴;신경심리측시유조우예측aMCI시부발전위AD.
Objective To investigate outcome and cognitive changes of amnestic mild cognitive impairment (aMCI) in a follow-up study. Methods A cross-sectional and longitudinal parallel cohort study design was conducted among 109 aMCI patients and 104 matched normal controls. Multi-dimension neuropsychologic tests were used to extensively assess the cognitive function. Results The scores of neuropsychologic tests in aMCI patients were significantly lower than those in the normal controls( all P＜0.01 ) ,with the largest impairment on 20minutes delayed recall of the auditory verbal memory test ( AVMT), which reflects episodic memory ( aMCI pa-tients :2.50 ± 1.48, normal controls :7.85 ± 1.59, Z = - 12.697, P ＜ 0.01 ); AD was diagnosed in 15 of the 69aMCI patients with a prevalence rate of 22% ,but none was converted to AD in the normal controls. The cognitivechanges of performance in AVMT, CDT, MMSE of the patients in aMCI group (( 3.77 ± 60.83 )%, (6.89 ±28.24) %, (6.13 ± 16.89) % respectively) were significantly poorer than those of the controls group(( - 10.75 ±27.46) %, ( - 5.23 ± 14.05 ) %, ( - 1.11 ± 8.26 ) % respectively) ( all P ＜ 0.05 ). At baseline, demented aMCIperformed poorer in AVMT, CFT, TMT, SDMT, CDT, MMSE when compared to stable. During the follow-up, demented aMCI groups performed significantly poorer than did stable subjects in AVMT, CFT, DST, VFT, SDMT,MMSE ( all P ＜ 0.05 ). Conclusion aMCI is a prodromal period of AD and characterized by episodic memory impairment. The neuropsychologic test is a predictive factor for aMCI to develop AD.