阿尔茨海默病患者的汉字阅读能力研究

目的:研究汉语文化背景下的阿尔茨海默病患者的阅读能力和失读的特点。方法:正常老人、轻、中、重度AD各20名,性别、年龄和教育程度匹配。4组受试简明精神状态量表(MMSE)总分分别为27.7±2.2分、21.2±2.2分、15.2±2.3分和6.9±2.6分。汉字阅读包括22个记号字、17个音符字和17个义符字。结果:不管是记号字、音符字还是义符字,在正常老人组、轻度AD组和中度AD组之间两两比较没有显著差异(P>0.05),音符字和义符字在中度和重度AD组之间比较有显著差异(P<0.01)。“视觉性错读”在四组之间没有显著差异(P>0.05),表层失读出现在AD早期,并在AD晚期明显加重,好发于声符与其本字的发音不一致的义符字,不能用左侧忽视来解释。深层失读仅出现在AD晚期。组词现象是汉字深层失读的主要类型。结论:可以通过汉字阅读能力的评估判断早期痴呆被试的病前智力。汉字失读的类型与西方语言不同。

Ability of Chinese Characters Reading in Patients with Alzheimer's Disease

Objective: To analyze the ability of Chinese characters reading and characteristics of alexia among patients with mild, moderate and severe Alzheimer's Disease(AD). Methods: Chinese characters reading test was performed in 20 normal controls(average MMSE total score is 27.7), 20 mild AD(average MMSE is 21.2),20 moderate AD(average MMSE is 15.2) and 20 severe AD(average MMSE is 6.9). Chinese characters reading test consists of 22 mark-symbol characters, 17 phonetic symbol characters and 17 meaning-symbol characters. Results: No significant difference were found in scores of Chinese characters reading test among normal controls, patients with mild, moderate AD group. Compared with moderate AD, severe AD showed manifest decline for scores of phonetic symbol characters and meaning-symbol characters reading. There wasn't significant different visual paralexia among 4 groups. Surface alexia occurred at early stage of AD and advanced at late stage of AD. These wrong reading were seen frequently in meaning-symbol characters. Deep alexia occurred only at late stage of AD. Compound words phanomenon is the major class of deep alexia. Conclusion: Ability of Chinese characters reading was helpful to estimate premorbid intelligence of the patients with dementia. There are different classes of alexia between Chinese and western languages.