【作者】 程灶火； 蔡德亮； 王志强； 李萍； 周晓琴；

【Author】 Wuxi Mental Health Center CHENG Zao-huo, CAI De-liang,WANG Zhi-qiang,et al.

【机构】 无锡市精神卫生中心；

【摘要】 目的:考查轻度认知损害(MCI)患者的神经心理损害模式和寻找MCI和AD痴呆早期诊断的神经心理学指标。方法:以139名社区正常老人、86名符合Petersen MCI诊断标准的社区样本和35名符合DSM-ⅣAD痴呆(DAT)标准的社区和临床患者为研究对象,用18项神经心理测验分别评估被试的内隐记忆、再认记忆、日常记忆、自由回忆、工作记忆、学习能力、推理能力、空间/计算和加工速度。结果:MCI组的神经心理测验成绩低于正常对照组、高于DAT组(P<0.001),尤其是自由回忆、工作记忆、学习能力和加工速度的组间差异更大;神经心理学指标能甄别正常与MCI或MCI与DAT,归类正确率在90.9%～93.8%之间;神经心理指标在MCI和DAT诊断中具有较高的敏感性和特异性,尤其是自由回忆、工作记忆、学习能力和加工速度,对MCI的敏感性分别为0.763、0.806、0.748和0.727,对DAT的敏感性分别为0.930、0.884、0.965和0.919,对MCI的特异性分别为0.779、0.733、0.837和0.826,对DAT的特异性分别为0.743、0.686、0.686和0.829。结论:自由回忆、工作记忆、学习能力和加工速度是MCI和AD早期可靠的神经心理学诊断指标。更多还原

【Abstract】 Objective:To investigate neuropsychological deficit pattern of mild cognitively impaired(MCI) patients and identify neuropsychological marker in the diagnosis of MCI and early Alzheimer’s disease.Methods:In present study,139 normal elderly controls,86 patients met Petersen MCI criteria,and 35 dementia with Alzheimer type(DAT) met DSM-Ⅳcriteria were selected from community and clinical sample,Eighteen neuropsychogical tests were used to assess subjects’ implicit memory, recognition,everyday memory,free recall,working memory,learning ability,reasoning ability, spatial/arithmetic,and processing speed.Results:Performances of the MCI were lower than normal control and higher than the DAT on the neuropsychological measures,particularly free recall,working memory, learning ability and processing speed(P<0.001);Neuropsychological measures discriminated MCI from normal elderly and DAT patients with accurately classified rate of 90.9%~93.8%;neuropsychological measures discriminated among normal controls,MCI and DAT,particularly free recall,working memory, learning ability and processing speed,with sensitivity of 0.763,0.806,0.748,and 0.727 for MCI,0.930, 0.884,0.965,and 0.919 for DAT;specificity of 0.779,0.733,0.837,and 0.826 for MCI,0.743,0.686,0.686, and 0.829 for DAT.Conclusion:free recall,working memory,learning ability and processing speed should be early and reliable neuropsychological marker in the diagnosis of MCI and AD.更多还原