目的 分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系.方法 选取 2016 年 1 月至 2022 年 12 月江西省人民医院收治的 90 例老年期痴呆患者为研究对象,根据随机数字表法将其分为常规组、对照组和观察组,每组各 30 例.常规组患者给予盐酸美金刚片治疗,对照组患者在常规组基础上加以音乐疗法,观察组患者在常规组基础上加以重复经颅磁刺激治疗,三组均连续治疗 12 周.比较三组患者的 BPSD 严重程度、痴呆严重程度、认知功能、日常生活能力、ApoE基因多态性.结果 治疗前,三组患者的神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)、简明精神状态检查量表(mini-mental state examination,MMSE)、日常生活能力评定量表(activity of daily living scale,ADL)评分比较差异均无统计学意义(P>0.05);治疗后,三组患者的NPI、CDR评分均显著低于本组治疗前,MMSE、ADL评分均显著高于本组治疗前(P<0.05);观察组和对照组患者的NPI、CDR评分均显著低于常规组,MMSE、ADL评分均显著高于常规组(P<0.05).ApoE共有ε2、ε3、ε4 三种等位基因,其中ε3 表达频率最高,共 55 例,其次为ε4 和ε2;三组患者的ApoE不同基因检出率比较差异无统计学意义(P>0.05).ApoE ε4 型患者的NPI评分显著高于ApoE ε3 型与ApoE ε2 型(P<0.05).结论 非药物治疗老年期痴呆患者效果显著,可减轻BPSD和痴呆表现,提高患者的认知功能和日常生活能力,ApoE ε4 型基因与老年期痴呆患者的BPSD存在紧密联系.
Clinical study on non-drug treatment of BPSD in senile dementia and its correlation with ApoE gene polymorphism
Objective To analyze the effect of non-drug therapy on behavioral and psychological symptom of dementia(BPSD)and its correlation with apolipoprotein E(ApoE)gene polymorphism.Methods A total of 90 patients with senile dementia admitted to Jiangxi Provincial People's Hospital from January 2016 to December 2022 were selected as study objects,they were divided into routine group,control group and observation group according to random number table method,with 30 cases in each group.Patients in routine group were treated with memantine hydrochloride tablets,patients in control group were treated with music therapy on the basis of routine group,patients in observation group were treated with repeated transcranial magnetic stimulation on the basis of routine group,and they were all treated for 12 weeks.BPSD severity,dementia severity,cognitive function,ability of daily living and ApoE gene polymorphism were compared among the three groups.Results Before treatment,there were no significant differences in the scores of neuropsychiatric inventory(NPI),clinical dementia rating(CDR),mini-mental state examination(MMSE)and activity of daily living(ADL)scale among the three groups(P>0.05).After treatment,the NPI and CDR scores of three groups were significantly lower than before treatment,and the MMSE and ADL scores were significantly higher than before treatment(P<0.05).The scores of NPI and CDR in observation group and control group were significantly lower than those in routine group,while the scores of MMSE and ADL were significantly higher than those in routine group(P<0.05).There were ε2,ε3 and ε4 alleles in ApoE,of which ε3 had the highest expression frequency(55 cases),followed by ε4 and ε2.There was no significant difference in detection rate of different ApoE genes among the three groups(P>0.05).The NPI scores of ApoE ε4 patients were significantly higher than those of ApoE ε3 and ApoE ε2 patients(P<0.05).Conclusion Non-drug therapy has a significant effect on senile dementia patients,which can effectively alleviate dementia and BPSD,improve cognitive function and daily living ability.ApoE ε4 gene is closely associated with BPSD in senile dementia patients.
Senile dementiaBehavioral and psychological symptom of dementiaApoE gene polymorphismCognitive functionDaily living ability
万方数据
维普
