中华精神科杂志
中華精神科雜誌
중화정신과잡지
CHINESE JOURNA OF PSYCHIATRY
2015年
2期
109-114
,共6页
陈淑玲%金建烽%阎同军%高志斌%孙剑%江景娟%徐乐平
陳淑玲%金建烽%閻同軍%高誌斌%孫劍%江景娟%徐樂平
진숙령%금건봉%염동군%고지빈%손검%강경연%서악평
阿尔茨海默病%吞咽障碍%视频吞咽造影检查%筛选
阿爾茨海默病%吞嚥障礙%視頻吞嚥造影檢查%篩選
아이자해묵병%탄인장애%시빈탄인조영검사%사선
Alzheimer's disease%Deglutition disorders%Videofluoroscopic swallowing study%Screening
目的 了解阿尔茨海默病(Alzheimer's disease,AD)患者吞咽障碍的发生率及临床特点.方法 自制量表调查239例轻中度AD患者人口学资料和临床特征,采用洼田饮水试验联合血氧饱和度监测对吞咽障碍患者进行初筛,初筛阳性者经视频吞咽造影检查确诊.结果 (1)AD患者吞咽障碍发生率为20.5％ (49/239),其中轻度AD和中度AD患者的吞咽障碍发生率分别为13.6％(18/132)、29.0％ (31/107);误吸发生率为7.5％ (18/239).(2)吞咽障碍患者中,年龄≥75岁、中度痴呆、使用抗精神病药、使用苯二氮(苲)类药、有吞咽困难临床表现、有吞咽困难相关体征者的比例显著高于无吞咽障碍者(x2=4.086 ～8.527,P=0.003 ～0.043).(3)Logistic回归分析显示,年龄≥75岁(OR=2.099)、中度痴呆(OR =2.310)、使用抗精神病药(OR=2.202)、有吞咽困难临床表现(OR=2.306)与吞咽障碍相关(P =0.016 ～0.039).结论 AD患者中吞咽障碍有一定普遍性,以高龄、痴呆程度较严重、使用抗精神病药或有吞咽困难临床表现者尤著.
目的 瞭解阿爾茨海默病(Alzheimer's disease,AD)患者吞嚥障礙的髮生率及臨床特點.方法 自製量錶調查239例輕中度AD患者人口學資料和臨床特徵,採用窪田飲水試驗聯閤血氧飽和度鑑測對吞嚥障礙患者進行初篩,初篩暘性者經視頻吞嚥造影檢查確診.結果 (1)AD患者吞嚥障礙髮生率為20.5％ (49/239),其中輕度AD和中度AD患者的吞嚥障礙髮生率分彆為13.6％(18/132)、29.0％ (31/107);誤吸髮生率為7.5％ (18/239).(2)吞嚥障礙患者中,年齡≥75歲、中度癡呆、使用抗精神病藥、使用苯二氮(苲)類藥、有吞嚥睏難臨床錶現、有吞嚥睏難相關體徵者的比例顯著高于無吞嚥障礙者(x2=4.086 ～8.527,P=0.003 ～0.043).(3)Logistic迴歸分析顯示,年齡≥75歲(OR=2.099)、中度癡呆(OR =2.310)、使用抗精神病藥(OR=2.202)、有吞嚥睏難臨床錶現(OR=2.306)與吞嚥障礙相關(P =0.016 ～0.039).結論 AD患者中吞嚥障礙有一定普遍性,以高齡、癡呆程度較嚴重、使用抗精神病藥或有吞嚥睏難臨床錶現者尤著.
목적 료해아이자해묵병(Alzheimer's disease,AD)환자탄인장애적발생솔급림상특점.방법 자제량표조사239례경중도AD환자인구학자료화림상특정,채용와전음수시험연합혈양포화도감측대탄인장애환자진행초사,초사양성자경시빈탄인조영검사학진.결과 (1)AD환자탄인장애발생솔위20.5％ (49/239),기중경도AD화중도AD환자적탄인장애발생솔분별위13.6％(18/132)、29.0％ (31/107);오흡발생솔위7.5％ (18/239).(2)탄인장애환자중,년령≥75세、중도치태、사용항정신병약、사용분이담(자)류약、유탄인곤난림상표현、유탄인곤난상관체정자적비례현저고우무탄인장애자(x2=4.086 ～8.527,P=0.003 ～0.043).(3)Logistic회귀분석현시,년령≥75세(OR=2.099)、중도치태(OR =2.310)、사용항정신병약(OR=2.202)、유탄인곤난림상표현(OR=2.306)여탄인장애상관(P =0.016 ～0.039).결론 AD환자중탄인장애유일정보편성,이고령、치태정도교엄중、사용항정신병약혹유탄인곤난림상표현자우저.
Objective To analyze the prevalence,related clinical factors of dysphagia in patients with Alzheimer's disease (AD).Methods A total of 239 mild or moderate AD patients were recruited and investigated with a self-administered questionaire on demographics and clinical characteristics.All subjects were screened by Kubota swallowing assessment combined with arterial oxygen saturation monitoring,and the positive cases were further confirmed by video fluoroscopic swallowing study (VFSS).Results The prevalence rate of dysphagia was 20.5％ (49/239),with 13.6％ (18/132)in mild and 29.0％ (31/107)in moderate AD patients.The rate of aspiration was 7.5％ (18/239).More subjects with age≥75yr,moderate dementia,antipsychotics or benzodiazepine therapia,any clinical features orsigns of dysphagia were found in patients with dysphagia than those without (x2 =4.086-8.527,P =0.003-0.043) Multiple logistic regression showed that the age of ≥75 yr (OR =2.099),moderate dementia (OR =2.310),antipsychotic treatment(OR =2.202),any clinical features of dysphagia (OR =2.306)were significantly associated with dysphagia in AD patients(P =0.016-0.039).Conclusion It is suggested that dysphagia is common in AD patients,especially in those with elder age,more severe dementia,antipsychotic treatment,and clinical features of dysphagia.
