CAJ | 학술논문

目的了解神经内科门诊55岁以上患者痴呆的就诊比例及各痴呆亚型的比例，探讨各痴呆亚型的临床特点；了解APOE基因与阿尔茨海默病的相关性。方法选取2009年9月25日到2009年12月25日在四川省人民医院神经内科门诊就诊的患者14286人为研究对象，分别用老年人认知功能减退知情者问卷（IQCODE）、简易精神状态量表（MMSE）、Hachinski 缺血指数量表（HIS）、日常生活能力量表（ADL）、神经精神问卷（NPI）、Hamilton抑郁量表、自发的画钟测验（CDT）、临床痴呆评定量表（CDR）量表进行检测，诊断痴呆患者进行抽血检查APOE基因。结果在所有就诊患者中阿尔茨海默病占1.99％；血管性痴呆占0.95％；混合性痴呆占0.47％；额颞叶痴呆占0.19％；其他类型痴呆占0.19％。在所有痴呆患者中阿尔茨海默病占52.5％，血管性痴呆占25％，混合性痴呆占12.5％，额颞叶痴呆占5％，其他类型痴呆占5％。阿尔茨海默病与混合性痴呆在即刻记忆、延迟记忆、长延迟再认的得分明显低于血管性痴呆；在定向力、判断力、计算力、日常生活能力方面的得分情况三者无差异；轻度阿尔茨海默病、混合性痴呆在Hamilton抑郁量表中的得分明显高于中重度阿尔茨海默病及血管性痴呆。中重度阿尔茨海默病及血管性痴呆在神经精神问卷中的得分明显高于轻度阿尔茨海默病及混合性痴呆。在自发的画钟测验方面，血管性痴呆得分要高于阿尔茨海默病及混合性痴呆。 APOEε4等位基因与阿尔茨海默病密切相关。结论阿尔茨海默病为主要的痴呆类型，其次为血管性痴呆、混合性痴呆、额颞叶痴呆及其他类型痴呆。阿尔茨海默病、血管性痴呆及混合性痴呆在认知功能损害方面存在差异。阿尔茨海默病与APOE4基因相关。
목적료해신경내과문진55세이상환자치태적취진비례급각치태아형적비례，탐토각치태아형적림상특점；료해APOE기인여아이자해묵병적상관성。방법선취2009년9월25일도2009년12월25일재사천성인민의원신경내과문진취진적환자14286인위연구대상，분별용노년인인지공능감퇴지정자문권（IQCODE）、간역정신상태량표（MMSE）、Hachinski 결혈지수량표（HIS）、일상생활능역량표（ADL）、신경정신문권（NPI）、Hamilton억욱량표、자발적화종측험（CDT）、림상치태평정량표（CDR）량표진행검측，진단치태환자진행추혈검사APOE기인。결과재소유취진환자중아이자해묵병점1.99％；혈관성치태점0.95％；혼합성치태점0.47％；액섭협치태점0.19％；기타류형치태점0.19％。재소유치태환자중아이자해묵병점52.5％，혈관성치태점25％，혼합성치태점12.5％，액섭협치태점5％，기타류형치태점5％。아이자해묵병여혼합성치태재즉각기억、연지기억、장연지재인적득분명현저우혈관성치태；재정향력、판단력、계산력、일상생활능력방면적득분정황삼자무차이；경도아이자해묵병、혼합성치태재Hamilton억욱량표중적득분명현고우중중도아이자해묵병급혈관성치태。중중도아이자해묵병급혈관성치태재신경정신문권중적득분명현고우경도아이자해묵병급혼합성치태。재자발적화종측험방면，혈관성치태득분요고우아이자해묵병급혼합성치태。 APOEε4등위기인여아이자해묵병밀절상관。결론아이자해묵병위주요적치태류형，기차위혈관성치태、혼합성치태、액섭협치태급기타류형치태。아이자해묵병、혈관성치태급혼합성치태재인지공능손해방면존재차이。아이자해묵병여APOE4기인상관。
Objective To investigate the visit rate of neurology outpatients with dementia over 55 years,the distribution and clinical feature of its subtypes ,the association between APOE genotypes and Alzheimer′s disease. Methods To detect APOE genotypes in the blood of dementia patients , diagnosed by cognitive function decline insiders questionnaire ( IQCODE ) , Mini Mental State scale ( MMSE ) , Hachinski Ischemic Index Scale ( HIS ) , activities of daily living scale ( ADL) ,Neuropsychiatric Questionnaire ( NPI) ,Hamilton Depression Scale ,spontaneous clock drawing test ( CDT) and clinical Dementia Rating Scale ( CDR) ,in 14 286 outpatients at the Sichuan Provincial People′s Hospital Neurology Clinic from September 25 2009 to December 25 2009 .Results Alzheimer′s disease (AD)accounted for 1.99%in all neurology outpatients,followed in order by vascular dementia(VD)0.95%,mixed dementia 0.47%, frontotemporal dementia 0.19%, other types of dementia 0.19%;in patients of dementias , AD accounted for 52.5%,VD 25%,mixed dementia 12.5%,frontotemporal dementia 5%,other types of dementia 5%. The scores of immediate memory ,delayed memory ,long-delayed recognition in AD and mixed dementia patients were lower than VD patients;No difference in AD , VD, mixed dementia patients′scores of orientation , judgment and calculation,the activities of daily living;Hamilton depression scale scores in Mild AD ,mixed dementiapatients were higher than the moderate to severe AD and VD patients;the mental test score of moderate and severe AD , VD patients,were higher than mixed dementia and mild AD;scores of Clock Drawing Task in VD patients were higher than AD patients .ApoEε4 allelic was closely related to AD .Conclusions AD is the main type of dementia ,followed successively by VD,mixed dementia,frontotemporal dementia,other types of dementia.AD,VD and mixed dementia patients have differences in cognitive impairment .APOE gene is related to AD .