摘要
目的:路易体痴呆的发病率是仅次于阿尔茨海默病的第2位痴呆症,约占痴呆患者的15%～25%。以波动性认知功能障碍、视幻觉和帕金森病综合征为路易体痴呆的特征性临床特点。方法:复习文献,分析路易体痴呆患者的病理改变和临床表现特点,了解其治疗和预后。结果:路易体痴呆的经典的病理特征是患者脑内出现路易小体,患者都有以下特点:①波动性、进行性痴呆。②形象具体、生动的视幻觉。③锥体外系症状。④对神经安定剂敏感。路易体痴呆需要与阿尔茨海默病、帕金森病和血管性痴呆进行鉴别,目前没有明确有效的治疗药物,预后较差,治疗主要是针对性的对症治疗,以改善其认知功能及行为障碍,生活护理指导及康复如进行语言、进食、走路等各种训练和指导对改善患者生活质量十分重要。结论:路易体痴呆是一种神经系统变性疾病,其病理改变和临床有特征性表现,对诊断明确的路易体痴呆患者应采取有针对性的治疗。
AIM： Dementia with Lewy body has ranked the second in the incidence of dementia, only inferior to Alzheimer disease, accounting for 15% to 25% of all dementia patients. Fluctuating cognitive impairment, visual hallucination, and Parkinsonism are all its clinical characteristics.METHODS： Pathological changes and clinical manifestation of dementia with Lewy body were analyzed as well as its treatment and prognosis through the review of literatures.RESULTS： The typical pathological characteristics were the presence of Lewy body. The clinical manifestations of patients were as follows： ① fluctuating progressive dementia; ② vivid visual hallucination; ③ extrapyramidal signs; ④ being sensitive to neuroleptic drugs. Dementia with Lewy body should be differentiated from Alzheimer disease, Parkinson disease and vascular dementia. There were no effective drugs in the treatment of dementia with Lewy body, and prognosis was generally poor. The main therapy for dementia with Lewy body was an allopathy with emphasis on the improvement of cognitive function and behavior disturbance through living nursing and instruction and some rehabilitative training on language,eating, walking and so on, which are important for patients to improve their quality of life.CONCLUSION： Dementia with Lewy body is a degenerative nervous system disease with obvious pathological and clinical characteristics. The allopathy should be done in the treatment of patients with dementia with Lewy body.
出处
《中国临床康复》
CSCD
北大核心
2005年第20期172-173,共2页
Chinese Journal of Clinical Rehabilitation
