老年期痴呆的临床分析

目的探讨老年期痴呆的危险因素、临床表现、影像学特点和诊断方法.方法对65例老年期痴呆患者的临床症状、神经心理、MRI检查结果进行综合分析,并以56例老年健康体检者为对照,总结各种痴呆的特点和诊断方法.结果65例老年期痴呆中,阿尔茨海默病（Alzheimer＇s,AD）35例（53.85%）,血管性痴呆（Vascular dementia,VD）19例（29.23%）,混合性痴呆（mixed dernentia,MD）7例（10.92%）,全身性疾病导致老年性痴呆4例（6.15%）.四种痴呆均存在记忆障碍,卒中病史在AD组中无,在VD组和MD组中分别为16例（84.21%）和3例（42.86%）;MRI显示患者有脑梗死灶、脑萎缩和脑白质疏松.结论老年期痴呆以AD最为多见,VD次之.不同痴呆各有不同的临床特点：AD起病慢,无神经系统局灶征,影像变化以脑萎缩为主;VD多有脑血管病史,起病急,有神经局灶征,影像变化以脑梗死为主;MD多兼有AD和VD的特点,脑血管病史不甚明确,影像学上既有脑萎缩又有散在的腔隙性脑梗死.

Clinical Analysis of Senile Dementia

Objective To probe into the risk factors, clinical manifestations, imaging characteristics and diagnostic methods of senile dementia. Methods Analyze the data of 65 cases senile dementia patients,including clinical symptoms, neuropsychology, MRI examination results, 56 cases of healthy elderly persons as comparison. Results Among 65 cases of senile dementia, Alzheimer＇s disease （AD） 35 （53.85%） cases, vascular dementia （VD） 19 （29.23%） cases, mixed dementia （MD） 7 （10.92%） cases, systemic diseases lead to senile dementia 4 cases （6.15 percent）. There are memory impairment four types of dementia,no history of stroke in AD group, the VD group and the MD group were 16 cases （84.21%） and three cases （42.86%）; MRI showed that patients with cerebral infarction lesions, and brain atrophy and brain white matter atrophy. Conclusion The AD is the most senile dementia, VD is second. Different dementia have different clinical features： AD onset slow, no nervous system local focus, the MRI image show brain atrophy mainly; VD has a history of cerebrovascular disease, acute onset, with nervous system local focus, the image changes in brain Infarction mainly; MD has both the characteristics of AD and VD, cerebrovascular disease history unclear, there are also brain atrophy and scattered infarction in image.