主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2017, Vol. 40 ›› Issue (4): 339-343.doi: 10.3969/j.issn.1006-2157.2017.04.014

• 临床研究 • 上一篇    下一篇

阿尔茨海默病证候变化与认知结局的关联性*

时晶1, 倪敬年1, 魏明清1, 张学凯1, , 李婷1, 康盛华1, 马福云1, 李雨濛1, 刘建平2, 王永炎3, 田金洲1#   

  1. 1 北京中医药大学东直门医院脑病三科 北京 100700;
    2 北京中医药大学循证医学中心;
    3 中国中医科学院中医临床基础医学研究所
  • 收稿日期:2017-01-16 出版日期:2017-04-30 发布日期:2017-04-30
  • 通讯作者: 田金洲,男,博士,教授,主任医师,博士生导师,研究方向:痴呆及相关疾病的中医药防治, E-mail:jztian@hotmail.com
  • 作者简介:时晶,女,博士,主任医师,博士生导师
  • 基金资助:
    *国家自然科学基金资助项目(No.81473518、No. 81573824、No.81503625),高等学校学科创新引智计划(No.B08006),首都卫生发展专项(No.2014-1-4191)

Association between pattern changes and cognitive outcome in Alzheimer’s disease*

SHI Jing1, NI Jingnian1, WEI Mingqing1, ZHANG Xuekai1, LI Ting1, KANG Shenghua1, MA Fuyun1, LI Yumeng1, LIU Jianping2, WANG Yongyan3, TIAN Jinzhou1#   

  1. 1 3rd Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700;
    2 Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine;
    3 Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences
  • Received:2017-01-16 Online:2017-04-30 Published:2017-04-30

摘要: 目的 探讨阿尔茨海默病(AD)证候变化与疾病指标认知功能变化的相关性。方法 招募阿尔茨海默病患者进行证候横断面调查并进行24周随访研究。年龄40~85岁,分认知正常, 轻度认知损害和痴呆3组。认知功能评估使用简易精神状态检查(MMSE)和阿尔茨海默病评价量表-认知部分(ADAS-cog),以临床医生整体印象加照料者补充的痴呆证候变化总体印象量表(CGIC-S)作为证候评价方法。结果 共383位受试者,对73例AD患者进行随访,46例(63%)完成24周随访。证候量表的克朗巴赫系数为0.836,组内相关系数为0.652(P<0.001),具有中等重测信度(r=0.561,P=0.004)。肾虚和髓减证随时间变化,其中肾虚证变化与ADAS-cog变化相关(r=0.401, P=0.003)。结论 肾虚为代表的证候变化与AD认知结局具有相关性,肾虚证候分数的变化能反映认知功能的变化,在一定程度上可作为AD结局指标。

关键词: 阿尔茨海默病, 证候, 认知功能, 临床试验

Abstract: Objective To explore the association between pattern changes and cognitive outcome in patients with Alzheimer’s disease (AD).Methods The study consisted of two parts: a cross-sectional survey and a follow-up. Adults with memory complaints aged 40 to 85 years were recruited. Participants were grouped into normal cognition (NC), mild cognitive impairment(MCI)and dementia. AD Patients were followed up over 24 weeks. The mini-mental state examination (MMSE) and Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog) were used for cognitive tests. Pattern diagnosis was made by using clinical global impression of change in syndrome(CGIC-S). Results 383 participants (100 NC, 120 MCI, 125 AD, and 38 other dementia) were recruited. 73 AD patients were followed up; 46 (63%) were retained at 24 weeks. The new scale had a Cronbach’s alpha of 0.836 and interclass correlation coefficient of 0.652 (P<0.001). 50 cases were selected for a test-retest analyses with 2 weeks’ interval, Pearson r was 0.561 (P=0.004). Kidney deficiency and marrow deficiency were the only two pattern elements changed over time;the pre-post change was related to ADAS-cog change (r=0.401, P=0.003). Conclusion Kidney deficiency subscale should be a fairish test for pattern change in AD clinical trials.

Key words: Alzheimer’s disease, pattern, cognitive function, clinical trial

中图分类号: 

  • R277.742