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背景:原发性进行性失语是以语言能力进行性下降,而记忆力相对保存的神经系统变性疾病。目的:通过对原发性进行性失语患者的1例报道,探讨其言语障碍特点和临床特征。设计:病例分析。单位:首都医科大学附属北京天坛医院神经内科。对象:选择2004-03在北京天坛医院神经内科就诊的患者1例。男,56岁,高中文化,2001年始出现不能说出日常生活用品名称,但听理解能力基本正常。2003年患者言语障碍进行性加重,听理解能力逐渐下降,但记忆力无明显减退,出现性格改变,不能正常工作;但生活可自理。方法:①采用汉语失语成套测验中的口语流利性评定标准评估患者的口语流利性患者的口语流利性;采用西部失语成套测验评估患者的失语症类型;采用波士顿诊断性失语严重程度分级标准对患者失语症的严重程度进行分级。②采用视觉词-图匹配、图形写名及口语阅读等认知心理学测试判定患者是否存在动-名词分离。③采用记忆量表对患者进行记忆力评估。主要观察指标:①观察患者的口语流利性、失语症类型及严重程度分级。②观察患者的动-名词分离情况。③观察患者的记忆力情况。结果:①失语症检查:患者自发谈话为流利型,有语义错语。为感觉性失语,失语症的严重程度为3级。②认知心理学测验:在图形写名测验中的动、名词正确率分别为15%,53%,差异明显(t=0.231,P<0.05)。③记忆力量表:记忆商为111,高于平常。结论:原发性进行性失语患者的临床表现以言语障碍最为突出,出现动词特异性损伤。
Background: Primary progressive aphasia is a neurodegenerative disorder characterized by progressive loss of speech ability and relatively memory. Objective: To investigate the characteristics and clinical features of speech disorders in one case of primary progressive aphasia. Design: Case Analysis. SETTING: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University. PARTICIPANTS: A case of patients who visited the Department of Neurology, Beijing Tiantan Hospital, 2004-03 was selected. Male, 56 years old, high school culture, appeared in 2001 can not say the names of daily necessities, but the basic understanding of listening ability. 2003 patients with progressive speech impairment, hearing ability to understand gradually declined, but no significant memory loss, personality changes, can not work; but life can take care of themselves. Methods: ① The colloquial fluency in Chinese aphasia test was used to evaluate the fluent oral English of patients with oral flu. The western aphasia test was used to evaluate the type of aphasia. The Boston Diagnostic Aphasia Scale The severity of aphasia is graded. ② The use of visual words - map matching, graphic writing name and spoken language reading and other cognitive psychology test to determine whether there is a moving patient - noun separation. ③ using memory scale memory evaluation of patients. MAIN OUTCOME MEASURES: ① Observe the patient’s fluent speech, the type of aphasia and the severity of the classification. ② observe the patient’s dynamic - noun separation. ③ observe the patient’s memory. Results: aphasia examination: patients spontaneous conversation is fluent, there are semantic mistakes. For sensory aphasia, the severity of aphasia is level 3. (2) Cognitive psychology test: The correct rates of verb and noun in the graphic name test were 15% and 53%, respectively, with significant difference (t = 0.231, P <0.05). ③ memory table: Memory is 111, higher than usual. Conclusion: The clinical manifestations of patients with primary progressive aphasia are the most prominent verbal disorders, verbal-specific injury appears.