THE AIDS DEMENTIA COMPLEX .1. CLINICAL-FEATURES
THE AIDS DEMENTIA COMPLEX .1. CLINICAL-FEATURES
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DOI：
10.1002/ana.410190602
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发表时间：
1986-06-01
影响因子：
11.2
通讯作者：
PRICE, RW
中科院分区：
文献类型：
--
作者：
NAVIA, BA;JORDAN, BD;PRICE, RW
在70例获得性免疫缺陷综合征（AIDS）尸检患者中，46例患有进行性痴呆，经常伴有运动和行为功能障碍。记忆力和注意力受损伴精神活动减慢是这种疾病最常见的早期表现，但在近一半的患者中，运动或行为变化占主导地位。早期运动缺陷通常包括共济失调、腿无力、震颤和精细运动协调的丧失，而行为障碍最常见的表现为冷漠或退缩，但偶尔表现为明显的器质性精神病。大多数患者的病程是稳步进展的，有时会突然加速。然而，在20%的患者中观察到更长的无痛病程。在这种疾病的最晚期，患者表现出严重痴呆、缄默症、失禁、截瘫以及在某些情况下肌阵挛的刻板印象。这种艾滋病痴呆综合症的高发病率和独特的临床表现与新出现的概念一致，即这种并发症是由于直接脑感染的逆转录病毒，导致艾滋病。
Of 70 autopsied patients with the acquired immune deficiency syndrome (AIDS), 46 suffered progressive dementia that was frequently accompanied by motor and behavioral dysfunction. Impaired memory and concentration with psychomotor slowing represented the most common early presentation of this disorder, but in nearly one half of the patients either motor or behavioral changes predominated. Early motor deficits commonly included ataxia, leg weakness, tremor, and loss of fine-motor coordination, while behavioral disturbances were manifested most commonly as apathy or withdrawal, but occasionally as a frank organic psychosis. The course of the disease was steadily progressive in most patients, and at times was punctuated by an abrupt accleration. However, in 20% of patients a more protracted indolent course was observed. In the most advanced stage of this disease, patients exhibited a stereotyped picture of severe dementia, mutism, incontinence, paraplegia, and in some cases, myoclonus. The high incidence and unique clinical presentation of this AIDS dementia complex is consistent with the emerging concept that this complication is due to direct brain infection by the retrovirus that causes AIDS.