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阿尔茨海默病(Alzheimer s disease,AD)是全面性大脑功能衰退,包括记忆、计算、理解判断、常识等高级认知功能。痴呆的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)是痴呆患者出现的知觉、思维内容、心境或行为的紊乱。将正电子发射计算机断层显像(positron emission photography,PET)应用于老年期疾呆的研究,在国外已经有不少报道,在国内仅处于起步阶段[1,2],对BPSD的研究目前以临床特点为主,影像学的研究报道不多。笔者拟用PET探讨有BPSD和无BPSD的AD患者之间局部脑葡萄代谢率(regional cerebral me… 相似文献
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目的 探讨阿立哌唑和利培酮口服液治疗门诊老年期痴呆精神行为症状(BPSD)的疗效和安全性.方法 将68例老年期痴呆伴BPSD患者随机分成阿立哌唑组35例,利培酮口服液组33例,疗程8周,采用痴呆病理行为评定量表(BEHAVE-AD)及激越性问卷(CMAI)评定疗效,采用治疗中需处理的不良反应症状量表(TESS)评定副反应.结果 两组治疗后第6、8周末BEHAVE-AD和CMAI评分与治疗前比较均显著下降(P<0.01),两组之间比较治疗前及治疗后各时间点比较BEHAVE-AD评分差异无统计学意义(P>0.05).两组不良反应比较,阿立哌唑组不良发生率明显低于利培酮口服液组,差异有统计学意义(P<0.01).结论 阿立哌唑和利培酮口服液治疗老年期痴呆伴发BPSD均有较好疗效,两者总体疗效、起效时间相当,而阿立哌唑的安全性优于利培酮口服液. 相似文献
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论坛:抗精神病药在痴呆中的应用抗精神病药治疗老年期痴呆精神行为症状的争议 总被引:1,自引:1,他引:0
老年期痴呆的临床表现除认知缺损和社会生活功能减退外,几乎所有病人在病程中都表现有精神行为症状,一般称为痴呆的精神行为症状(behavioralandpsychologicalsymptomsofdementia,BPSD)。 相似文献
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目的:探讨农村老年痴呆患者精神行为症状(BPSD)的特点及其相关因素。方法:应用阿尔茨海默病病理行为评分量表对77例上海青浦区农村地区老年痴呆患者的病理性行为进行评定,并分析其相关因素。结果:老年痴呆患者BPSD发生率为89.6%,其中以行为紊乱、攻击性行为、日夜节律紊乱和偏执与妄想多见。BPSD与性别、年龄、文化程度和病程无相关,轻、中度痴呆患者偏执和妄想症状较重度明显,阿尔茨海默病和血管性痴呆BPSD相似。结论:农村老年痴呆患者BPSD发生率较高。 相似文献
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痴呆的精神行为症状的临床特征、基础及治疗研究进展 总被引:10,自引:0,他引:10
在传统观念中 ,痴呆的标志就是认知功能的全面减退 ,包括记忆和执行功能的逐步丧失 ,伴随以进行性加重的失语、失用。随着对痴呆研究的逐步深入 ,其非认知功能症状已越来越引起研究者的兴趣。非认知症状包括抑郁、精神病性症状、行为紊乱、昼夜节律紊乱等 ,国际老年精神病协会称之为痴呆的精神行为症状 (behavioraland psychologicalsymptomsofdementia,BPSD)。BPSD在老年痴呆患者中的发生率很高 ,是造成痴呆患者住院、照料者痛苦的主要原因。Schnaider等[1] 对 71例社区阿尔茨海默病 (AD)患者进行研究后发现 ,每年用于处理BPSD的间接… 相似文献
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阿尔茨海默病行为和精神症状及相关因素研究 总被引:4,自引:0,他引:4
目的 探讨阿尔茨海默病(AD)行为和精神症状(BPSD)的特点及其相关因素.方法 对符合美国精神障碍诊断和统计手册第四版修正版(DSM-IV-R)诊断标准的46例住院AD患者,进行一般资料调查,评定简易智力状态检查(MMSE)、临床痴呆评定表(CDR)、AD病理行为评分表(BEHAVE-AD)及日常生活能力量表(ADL),分析BPSD症状特点及与有关因素的关系.结果 BPSD的发生率为100%,其中以行为紊乱发生率最高(91.3%).幻觉发生率以重度AD最高(47.6%),MMSE分值与BEHAVE-AD幻觉分量表分呈负相关(P<0.05).患者年龄与BEHAVE-AD行为紊乱、日夜节律紊乱分量表分和总分呈负相关(P<0.05或P<0.01).ADL分值与BEHAVE-AD幻觉、行为紊乱、日夜节律紊乱分量表分及总分呈正相关(P<0.05).结论 住院AD患者BPSD的发生率非常高,应引起临床足够的重视.幻觉的出现可作为AD痴呆严重度的预警因素.AD患者BPSD可能与年龄和日常生活能力有关. 相似文献
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阿尔茨海默病载脂蛋白E基因多态性研究 总被引:7,自引:1,他引:7
目的:探讨载脂蛋白E(APoE)基因与阿尔茨海默病(AD)的行为和精神症状之间的关系。方法:采用聚合酶链式反应(PCR)扩增技术和限制性片段长度多态性(RFLP)技术测定85例AD病人的APOE基因多态性;采用AD病理行为量表评定病人的行为和精神症状。结果:对各等位基因及基因型频率分布在有无某项痴呆的行为和精神症状(BPSD)之间进行比较,发现具有行为紊乱症状的病人的ε2等位基因频率分布显著高于无行为紊乱症状的病人;无焦虑和恐惧病人的ε2等位基因频率分布显著高于有症状的病人。AD病人伴有BPSD症状及其严重程度,各基因型之间差异均无显著性。结论:ε2等位基因可能与行为紊乱、焦虑和恐惧症状有一定关联,而APoE基因与阿尔茨海默病的其它行为和精神症状之间未发现关联。 相似文献
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目的:探讨齐拉西酮和氟哌啶醇对老年期痴呆患者精神行为症状(BPSD)的疗效和安全性。方法:将60例老年期痴呆伴BPSD患者随机分成两组,分别使用齐拉西酮和氟哌啶醇治疗8周,采用痴呆病理行为评定量表(BEHAVE-AD),激越行为量表(CMAI)及治疗中出现的症状量表(TESS)评定疗效和不良反应。结果:两组治疗前后BEHAVE-AD和CMAI评分显著下降(P〈0.01),两组患者之间治疗前后BEHAVE-AD总减分值差异无统计学意义(P〉0.05),但情感障碍和焦虑两因子减分值差异有统计学意义(P〈0.05)。结论:齐拉西酮和氟哌啶醇治疗老年期痴呆患者BPSD的疗效相当,齐拉西酮的优势在于对情感障碍和焦虑的疗效更加明显,锥体外系不良反应轻。 相似文献
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Alzheimer病患者精神科门诊现状调查 总被引:5,自引:0,他引:5
目的了解Alzheimer病(AD)患者精神科门诊的现状.方法调查1997年1月至1999年6月期间在我院首次门诊时诊断为AD的124例患者的门诊记录.结果①AD病人首次门诊时的年龄76.58±8.46岁,病程(2.63±2.04)年.轻度AD44例(35.5%),中度AD 49例(39.5%),重度AD 31例(25%).②首次门诊时有行为和精神症状(BPSD)者110例(88.7%),AD常见的BPSD为妄想、攻击行为、睡眠不良、幻听、行为紊乱、外跑、抑郁情绪和性格改变等.③一次门诊者47例(37.9%),门诊的依从性与病人的年龄、性别、婚姻、病程、严重度和有无BPSD无关.结论AD病人的诊治常被延误,BPSD是痴呆的重要症状,AD病人门诊的依从性差. 相似文献
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Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system. 相似文献
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Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat. 相似文献
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Aarsland D Kvaløy JT Andersen K Larsen JP Tang MX Lolk A Kragh-Sørensen P Marder K 《Journal of neurology》2007,254(1):38-45
Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated
with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim
of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of
age.
Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups
of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed
for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological
and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore
the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables.
Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to
develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased
relative effect of age on the time to develop dementia in PD cases compared with controls.
Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects
with PD.
Received in revised form: 22 December 2005 相似文献
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Seelhorst RM 《Psychiatrische Praxis》2000,27(Z2):S64-S67
After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels. 相似文献
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Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults 总被引:9,自引:0,他引:9
Suominen S Helenius H Blomberg H Uutela A Koskenvuo M 《Journal of psychosomatic research》2001,50(2):77-86
A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health. 相似文献