Abstract: Objective To analyze neuropsychiatric symptoms in patients with vascular dementia (VaD). Methods Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE) and Hachinski Ischemia Score (HIS) were used to assess the neuropsychiatric symptoms in 81 cases with VaD, 35 cases with post-stroke non-dementia (PS-ND), 58 cases with Alzheimer's disease (AD) and 61 cases with normal elders as control group. Results Presentation of delusion, hallucination, agitation, depression and (or) dysthymia, apathy, irritability and (or) lability, aberrant action behavior, and NPI total scores in VaD group were significantly more than those in control group (P < 0.05 or P < 0.01). Delusion was more often seen in AD group than that in VaD group, and the difference was significant (P < 0.01). Hallucination, anxiety, apathy, irritability and (or) lability, and aberrant action behavior were significantly different among VaD with different severity (P < 0.05 or P < 0.01). These symptoms were all more obvious along with the patients' condition. Conclusion Various neuropsychiatric symptoms in VaD are similar to those in AD. The predominant neuropsychiatric symptoms are emotional and affective disturbance in patients with moderate and severe VaD.

Key words: Dementia, vascular, Alzheimer disease, Neuropsychological tests

摘要： 目的   了解血管性痴呆患者的神经精神症状特点。方法   采用神经精神科问卷、简易智能状态检查量表和Hachinski缺血评分量表，分别评价血管性痴呆、脑卒中后非痴呆、阿尔茨海默病和正常老年人群的神经精神症状。结果   与正常对照组比较，血管性痴呆组患者在妄想、幻觉、激越、抑郁和（或）心境恶劣、情感淡漠、易激惹和（或）不稳定、迷乱的动作行为等调查内容和神经精神科问卷总评分，差异有统计学意义（P < 0.05 或P < 0.01）；阿尔茨海默病组伴妄想者多于血管性痴呆组，组间差异有统计学意义（P < 0.01）。血管性痴呆不同严重程度组之间比较，幻觉、焦虑、情感淡漠、易激惹和（或）不稳定、迷乱的动作行为等调查项目达到统计学意义（P < 0.05 或P < 0.01），且随病情的逐渐加重而症状更为明显。结论   血管性痴呆和阿尔茨海默病患者存在多种相似的神经精神症状，中至重度血管性痴呆患者表现为以情绪和情感障碍为主的神经精神症状。

关键词: 痴呆, 血管性, 阿尔茨海默病, 神经心理学测验