记忆门诊“环路式体系”对阿尔茨海默病管理的应用效果

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摘要目的探讨记忆门诊“环路式体系”对阿尔茨海默病管理的应用效果。方法回顾性分析“环路式体系”开展前（2017年1月至12月）和开展后（2020年1月至12月）于广州市第一人民医院神经内科首次就诊并确诊为阿尔茨海默病的298例患者的临床资料，将2020年1月至12月首诊的患者作为研究组（179例），将2017年1月至12月首诊的患者作为对照组（119例）。按照国内外相关指南和共识，结合自身特点，规范记忆门诊管理体系，形成“社区-门诊筛查-诊断-综合干预-回归社区”的“环路式体系”综合管理模式。比较两组首诊时选择记忆门诊的患者比例、痴呆严重程度、辅助检查和相关评估量表的完成率。结果研究组首诊选择记忆门诊就诊率高于对照组，差异有统计学意义（P＜0.05），研究组的轻度认知障碍比例高于对照组，差异有统计学意义（P＜0.05），研究组的验血套餐、神经精神量表(NPI)、蒙特利尔认知评估量表（MoCA）、日常生活能力量表（ADL）完成率和脑脊液生物标志物送检率均高于对照组，差异有统计学意义（P＜0.05）；两组的简明精神状态量表（MMSE）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）和影像学检查完成率比较，差异无统计学意义（P＞0.05）。结论记忆门诊“环路式体系”促进疾病早期筛查、规范化诊治，尤其是对疾病干预前移有一定的促进作用。

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	郭爱华
	潘小平

关键词 ：认知障碍, 阿尔茨海默病, 轻度认知障碍, 记忆门诊, 管理

Abstract：Objective To explore the effect of application of the loop system in memory clinic on Alzheimer′s disease management.Methods A retrospective analysis was performed on the clinical data of 298 patients diagnosed with Alzheimer′s disease who were admitted to the Department of Neurology of Guangzhou First People′s Hospital for the first time before the implementation of "loop system"(from January 2017 to December)and after the implementation of "loop system"(from January 2020 to December).Patients first diagnosed from January 2020 to December were included in the study group (179 cases),and patients first diagnosed from January 2017 to December were included in the control group (119 cases).According to the relevant guidelines and consensus at home and abroad,a loop system consisting of community,outpatient screening and diagnosis,comprehensive intervention and return to the community was formed as a comprehensive management mode through standardizing the memory clinic management system,in combination with their own characteristics.The rate of patients who selected memory clinic for the first visit,severity of dementia,completion rates of auxiliary examination and related assessment scales were compared between the two groups.Results The rate of patients who selected memory clinic for the first visit of study group was higher than that in the control group,with statistically significant difference(P＜0.05).The proportion of mild cognitive impairment in study group was higher than that in control group,and the difference was statistically significant(P＜0.05).The completion rate of blood test package,neuropsychiatric inventory (NPI),Montreal cognitive assessment(MoCA),activity of daily living scale (ADL),the delivery rate of cerebrospinal fluid biomarkers were higher than those in the control group,the differences were statistically significant(P＜0.05).There were no significant difference in the completion rates of imaging examination,mini-mental state examination(MMSE),Hamilton anxiety scale(HAMA)and Hamilton depression scale (HAMD)between the two groups(P＞0.05).Conclusion The "loop system" of memory clinic can promote the early screening and standardized diagnosis and treatment of diseases,especially the advancement of disease intervention.

Key words： Cognitive impairment Alzheimer&prime s disease Mild cognitive impairment Memory clinic Administration

基金资助:广东省医学科学技术研究基金项目(B2018102)；广东省广州市临床高新技术项目（2019GX06）。

通讯作者: 潘小平（1959-），女，主任医师，研究方向：睡眠障碍、认知障碍、神经心理。

作者简介: 郭爱华（1979-），女，硕士，副主任医师，研究方向：神经退行性疾病与认知障碍。

引用本文:

郭爱华；潘小平. 记忆门诊“环路式体系”对阿尔茨海默病管理的应用效果[J]. 中国当代医药, 2021, 28(31): 74-77转81.
GUO Ai-hua；PAN Xiao-ping. Effect of application of the loop system in memory clinic on Alzheimer's disease management. 中国当代医药, 2021, 28(31): 74-77转81.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I31/74

[1]	Lynch C.World Alzheimer Report 2019：Attitudes to dementia，a global survey：Public health：Engaging people in ADRD research[J].Alzheimers Dement，2020，16（10）.
[2]	Jurgilait M,Beranskyt A.People′s perceptions of Alzheimer′s disease in Lithuania[J].Eur J Public Health，2020（5）：1056.
[3]	McKhann G，Drachman D，Folstein M，et al.Clinical diagnosis of Alzheimer′s disease：report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer′s Disease[J].Neurology，1984，34（7）：939-944.
[4]	Jack CR，Albert MS，Knopman DS，et al.Introduction to the recommendations from the National Institute on Aging-Alzheimer′s Association work groups on diagnostic guidelines for Alzheimer′s disease[J].Alzheimers Dement，2011，7（3）：257-262.
[5]	Albert MS，DeKosky ST，Dickson D，et al.The diagnosis of mild cognitive impairment due to Alzheimer′s disease：Recommendations from the National Institute on Aging-Alzheimer′s Association work groups on diagnostic guidelines for Alzheimer′s disease[J].Alzheimers Dement，2011，7（3）：270-279.
[6]	Vedel I，Sourial N，Arsenault-Lapierre G，et al.Impact of the Quebec Alzheimer Plan on the Detection and Management of Alzheimer Disease and Other Neurocognitive Disorders in Primary Health Care：A Retrospective Study[J].CMAJ，2019，7（2）：391-398.
[7]	余婉雯，欧阳樱君.广州市老城区长者认知状况调查报告[J].社会与公益，2019（3）：62-78.
[8]	Ansai JH，Andrade LPD，Masse F，et al.Risk Factors for Falls in Older Adults With Mild Cognitive Impairment and Mild Alzheimer Disease[J].J Geriatr Phys Ther，2019，42（3）：116-123.
[9]	James BD，Bennett DA.Causes and Patterns of Dementia:An Update in the Era of Redefining Alzheimer′s Disease[J].Annu Rev Public Health，2019，40（1）：65-84.
[10]	任汝静，王刚，陈生弟.对构建我国规范化记忆门诊的思考和展望[J].内科理论与实践，2015，10（2）：90-91.
[11]	冯靓，吴文秀，谢莹，等.神经内科记忆门诊认知障碍患者分布情况及治疗依从性随访观察[J].温州医科大学学报，2015，45（11）：827-830.
[12]	中国痴呆与认知障碍写作组，中国医师协会神经内科医师分会认知障碍疾病专业委员会.2018中国痴呆与认知障碍诊治指南（二）：阿尔茨海默病诊治指南[J].中华医学杂志，2018，98（13）：971-977.
[13]	中国痴呆与认知障碍诊治指南写作组，中国医师协会神经内科医师分会认知障碍疾病专业委员会.2018中国痴呆与认知障碍诊治指南（四）：认知障碍疾病的辅助检查[J].中华医学杂志，2018，98（15）：1130-1142.
[14]	中国痴呆与认知障碍诊治指南写作组，中国医师协会神经内科医师分会认知障碍疾病专业委员会.2018中国痴呆与认知障碍诊治指南（三）：痴呆的认知和功能评估[J].中华医学杂志，2018，98（15）：1125-1129.
[15]	田金洲，王荫华，王华丽，等.中国阿尔茨海默病痴呆诊疗指南(2020 年版)[J].中华老年医学杂志，2021，40（3）：269-283.
[16]	Lewczuk P，ukaszewicz-Zajac M，Mroczko P，et al.Clinical significance of fluid biomarkers in Alzheimer′s Disease[J].Pharmacol Rep，2020，72（1）：528-542.
[17]	Zhao A，Li Y，Yan Y，et al.Increased prediction value of biomarker combinations for the conversion of mild cognitive impairment to Alzheimer′s dementia[J].Transl Neurodegener，2020，9（1）：30-35.
[18]	Jester DJ，Andel R，Cechová K，et al.Cognitive Phenotypes of Older Adults with Subjective Cognitive Decline and Amnestic Mild Cognitive Impairment：The Czech Brain Aging Study[J].J Int Neuropsychol Soc，2020：1-14.
[19]	Orth J，Li Y，Simning A，et al.Nursing Home Residents with Dementia Experience Better End of Life Care and Outcomes in Nursing Homes with Alzheimer′s Special Care Units[J].Health Serv Res，2020，55（1）：19.