不同严重程度血管性痴呆与老年性痴呆的神经心理特点

目的 探讨不同严重程度的血管性痴呆（vascular dementia，VaD）与老年性痴呆（Alzheimer disease，AD）
的神经心理学特点。
方法 对广东省人民医院神经科门诊及病房的252例痴呆患者（VaD组127例，AD组125例），和正常对
照组159例进行一组神经心理量表检查。神经心理量表包括：简易精神状态检查（mini-mental state
examination，MMSE）、Fuld物体记忆测验（fuld object memory，FOM）、言语流畅性测验（rapid verbal
retrieve，RVR）、数字广度测验（digit span，DS）和积木测验（block design，BD）。分析这两种类型不同
严重程度的痴呆患者认知障碍的特点。
结果 两种类型的轻、中、重度痴呆患者神经心理检查有统计学差异（P <0.01）。轻度痴呆患者MMSE、
RVR评分在VaD、AD组间存在统计学差异（P <0.05），在中、重度痴呆患者，神经心理评分在VaD、AD组
间无统计学差异（P >0.05）。
结论 神经心理量表评估有助于VaD、AD的严重程度分级，RVR测验可辅助鉴别诊断轻度VaD和AD。

Profiles of Neuropsychological Impairment in Vascular Dementia and Alzheimer's Disease

Objective To study the neuropsychological characteristics between different severity of vasculardementia(VaD) and Alzheimer’s disease(AD).Methods The patients in Guangdong general hospital, 252 patients with(125 patients with AD,127 patients with VaD) and 159 normal control cases were included. Patients underwent a seriesof neuropsychological assessment including Mini-mental state examination(MMSE), Fuld-Object-Memory Evaluation(FOM), Rapid Verbal Retrieve(RVR), Block Design(BD), and Digit Span(DS).We analyzed the neuropsychological characteristics in AD and VaD patients.Results Scores on all tests had significant differences between different severity groups(P <0.01).In mild group, VaD patients had poorer scores in MMSE, RVR than AD(P <0.05). In moderate andsevere group, scores on all tests were no difference(P >0.05) between VaD and AD.Conclusion Neuropsychological assessment can help grade the severity of AD and VaD. RVR testcan assist the differential diagnosis of mild AD and VaD.