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| 1 | 35例路易体痴呆临床特点分析显示文摘目的了解中国路易体痴呆(DLB)的临床特点,提高临床诊治水平。方法电子检索中国生物医学文献数据库和中国知识仓库医学专题全文数据库1980~2012年收录的DLB病例报告,并分析其临床特点。结果共纳入18个研究35例患者,其中男26例,女9例。平均起病年龄(67.2±9.8)岁。以记忆力减退起病者占58.8%,以帕金森综合征起病者占11.8%,以视幻觉起病者占8.8%,以强迫症为首发症状占2.9%,以3种核心症状中的两种同时起病者占17.6%。随着病程的进展,68.6%的患者有波动性认知功能障碍,97.1%的患者有视幻觉,100%的患者有帕金森综合征,81.8%的患者对神经镇静药高度敏感,22.9%的患者有睡眠行为障碍,40.0%的患者有反复跌倒,17.1%的患者有短暂意识丧失,85.7%的患者有精神症状。26例患者行简易精神状态量表(MMSE)检查,评分均≤24分。影像学检查中,29.4%行头颅CT或MRI检查的患者显示海马和颞叶中部结构相对保留。3例患者行SPECT/PET检查,1例提示枕叶葡萄糖代谢减低。脑电图检查患者中63.2%表现为基本节律慢化,波率调节差,额、颞叶区明显。结论 DLB患者多在老年期发病,波动性认知功能障碍、视幻觉和帕金森综合征为3大核心症状,可合并存在。神经心理学、影像学及脑电图检查有一定诊断及鉴别诊断的价值。 | 王琼 韩丁 陈彤 王振福 | 2013 | 中华保健医学杂志2013，15，2： | 5 |
| 2 | Clinical features of dementia with lewy bodies in 35 Chinese patients显示文摘Objective:To investigate the clinical features of dementia with Lewy bodies(DLB)in a Chinese population.Methods:Computer-based online searches through China Biology Medicine disc and China National Knowledge Infrastructure were performed to collect case reports of DLB published between 1980 and 2012.Clinical characteristics were analyzed.Results:A total of 18 studies comprising 35 patients(26 males and 9 females)were included.The mean age at onset was 67.2±9.8 years.Onset was characterized by memory impairment and accounted for 58.8%of all cases,followed by parkinsonism(11.8%),visual hallucinations(8.8%),and compulsive personality disorder(2.9%).The other patients(17.6%)presented two of the three core features of DLB at onset.With disease progression,parkinsonism was reported in 100%of cases,followed by visual hallucinations(97.1%),psychiatric symptoms(85.7%),severe neuroleptic sensitivity(81.8%),fluctuating cognition(68.6%),repeated falls(40.0%),sleep disorders(22.9%),and transient loss of consciousness(17.1%).26 patients who were subjected to Mini-Mental State Examination scored≤24.10 patients presented relative preservation of hippocampus and medial temporal lobe structures on CT/MRI scan.Occipital hypometabolism occurred in 2 of 3 patients who underwent SPECT/PET perfusion scan.12 patients showed an increasing of slow frequency activity on EEG,prominently in frontal and temporal lobes.Conclusions:DLB often strikes elderly individuals.Its clinical core features are dementia,fluctuating cognition,recurrent visual hallucinations and spontaneous features of parkinsonism.Neuropsychological,neuroimaging and EEG examinations may improve the diagnostic accuracy and discriminate DLB from other dementias. | Ding Han Qiong Wang Zhongbao Gao Tong Chen Zhenfu Wang | 2014 | Translational Neurodegeneration2014，3，1： | 2 |
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