阿尔茨海默病患者出现精神行为症状的相关因素分析

目的 探讨阿尔茨海默病（AD）患者出现精神行为症状（BPSD）的相关因素。方法 对门诊和住院的155例符合精神障碍诊断与统计手册第4版（DSM-IV）诊断标准的AD患者，进行自制调查表、AD病理行为评分表（BEHAVE-AD）、痴呆行为量表（DBD）评定。结果 AD患者BPSD的相关因素分析发现：（1）AD患者DBD总分、BEHAVE-AD及妄想总分均与AD患者性格、年龄、婚姻状况及发病年龄相关，行为紊乱总分与患者的年龄、婚姻状况、性格相关，情感障碍与性格、发病前的生活事件及病程相关，焦虑恐惧与AD患者发病前的生活事件及病程相关，节律紊乱与性格和嗜好相关，攻击行为与婚姻状态及性格有关；（2）线性回归分析发现性格、婚姻状况对DBD与BEHAVE-AD总分有较大的影响。结论 AD患者BPSD的相关因素有年龄、性格、婚姻状况、嗜好、发病前生活事件、发病年龄、AD病程等；关系较为密切的有：性格、婚姻状况；推测外向性格和婚姻不稳定有可能是AD患者出现BPSD的危险因素。

Study on related factors of behavior-psychological symptoms of dementia in patients with Alzheimer disease

Objective To study the related factors for behavior and psychological symptoms of dementia (BPSD) in patients with Alzheimer disease (AD). Methods One hundred and fifty-five patients with AD, who were diagnosed according to the diagnostic and statistical manual of mental disorders- fourth Edition (DSM-IV) criteria, were evaluated using the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) rating scale, the dementia behavior disturbance scale (DBD) and self-made questionnaire. Results (1) The scores of DBD, BEHAVE-AD and delusion in AD patients were related with character, age, marriage and onset age. Mood disorder was related with character, life event before onset and course of the disease. Rhythm disorder was related with character and hobby. Aggressive behavior was related with marriage and character. (2) Character, marriage were significantly associated with BPSD in linear regression analysis. Conclusions The related factors of BPSD in AD patients are age, character, marriage, hobbies, life event before onset of AD, onset age, and course of the disease. Extroversion character and unstable marriage are risk factors for BPSD in AD patients.