摘要目的 对比阿茨海默病(AD)、行为变异型额颞叶痴呆(bv-FTD)语言特点,明确语言检查在两者诊断和鉴别诊断中的价值. 方法在北京医院记忆门诊收集的17例bv-FTD、18例AD和18例健康对照通过听理解、复述、命名、说、朗读、阅读理解、书写7个检查项目从听、说、读、写4个方面进行语言特点比较. 结果 三组的语言总成绩(单位:分)中说(AD=128±46,bv-FTD=113±19,对照=158±13,F=23.34,P=0.049)和写(AD=8±5,bv-FTD=8±4,对照=11±1,F=27.07,P=0.000)差异有统计学意义;听理解成绩有产生差异的趋势(F=20.96,P=0.060);复述、命名、朗读和阅读理解成绩均差异无统计学意义(均P＞0.05).bv-FTD组在听理解、命名、说下属的多个项目成绩较对照显著受累(均P＜0.05);AD组和对照组在听理解、命名和说的下属项目的成绩差异具有统计学意义(均P＜0.05).AD和bv-FTD组间比较时,仅在物品命名(AD=51±19,bv-FTD=47±13,P=0.037),语法(AD=6±1,bv-FTD=6±1,P=0.010)和觅词(AD=6±1,bv-FTD=6±1,P =0.021)方面差异有统计学意义. 结论详细的语言检查有助于AD和bv-FTD患者的筛查,但是对于两种痴呆的鉴别诊断作用有限,需要结合其他检查来进行.

abstractsObjective To investigate and compare the language features among patients with behavioral variant frontotemporal dementia(bv-FTD),Alzheimer's disease(AD) and healthy controls,and to determine the clinical value of language tests in the diagnosis and differential diagnosis of the two kinds of dementia diseases.Methods A total of 17 bv-FTD patients,18 AD patients and 18 healthy controls were enrolled in Beijing hospital from Nov.2012 to Dec.2013.The language performances in four aspects of listening,speaking,reading and writing by seven items of listening comprehension,repetition,naming,speaking,read aloud,reading comprehension and writing were compared by using the one-way analysis of variance(ANOVA)and least significant difference(LSD)tests.Results There were significant differences among the three groups in speaking general scores (AD 128± 46,bv-FTD 113 ± 19,controls 158 ± 13) (F =23.34,P =0.049) and in writing (AD 8 ± 5,bv-FTD 8 ± 4,controls 11 ± 1) (F =27.07,P =0.000).A t rend of statistical difference was observed in general scores of listening comprehension(F =20.96,P =0.060).No difference was found in general scores of repetition,in naming,in reading aloud and in reading comprehension(all P ＞ 0.05).As compared with controls,bv-FTD patients were comprehensively impaired in sub-items of listening comprehension,in naming and in speaking(all P ＜0.05).As compared with controls,AD patients were significantly impaired in a few sub-items of listening comprehension,in naming and in speaking(P ＜0.05).There were significant differences in naming objects,grammar and word finding between AD patients and bv-FTD patients(51± 19 vs.47±13,6±1 vs.6±1,6±1 vs.6±1,P=0.037,0.010 and 0.021,respectively).Conclusions The detailed language examinations are helpful for screening AD and bv-FTD.However,the values are limited in the differential diagnosis between the two types of dementia diseases.It is necessary to combine the detailed language examinations with other tests.