血管性痴呆和阿尔茨海默病认知功能障碍与病理改变关系的探讨  

Studty the relationship of Congnitive Dysfunction and pathological change between vascular dementia and Alzheimer’s disease

作　　者：戴艳萍[1] 冯涛[1] 遇亚南[1] 靳美[1] 曹利[1] 

机构地区：[1]黑龙江省医院南岗分院神经内科,黑龙江哈尔滨150001

出　　处：《中风与神经疾病杂志》2006年第5期548-551,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨血管性痴呆(vascular dementia,VD)、阿尔茨海默病(Alzheimer’s disease,AD)认知功能障碍与病理改变的关系。方法采用MRI技术测定VD30例、AD20例患者脑叶和海马体积。应用MMSE评定受试者认知功能。结果不同痴呆阶段的VD和AD患者有着不同的临床特征,两者之间的鉴别指标随痴呆的进展而变化。头部MRI对AD患者海马测定显示萎缩明显,VD患者虽然也有不同程度的海马萎缩,但萎缩程度明显低于AD患者(P<0.01);与此对应,AD患者的颞角也较VD患者明显加深(P<0.05),为海马萎缩的间接证据。VD患者MMSE评分的降低与额叶、颞叶萎缩程度呈正相关。头部MRI对VD患者的测定显示多发病灶较单发病灶、双侧病灶较单发病灶、病灶总体积大于50mm3较小于50mm3的患者,认知功能评分的降低亦更显著。结论VD和AD具有不同的临床特征,两者间的差别是由各自的病变性质、部位和病理生理机制所决定的。Objective Study the relationship of congitive dysfunction and pathological change between vascular dementia and Alzheimer’s disease. Methods Adopting MRI technology to determine the cerebral lobes and hippocampal volume of 30 VD cases and 20 AD cases. Appling MMSE to evaluate the congnitive dysfunction of subjects. Results VD and AD patients have different clinical features in various demented stages,hence the differentiate indexes of two were changed according to dementia subtypes. It is shown from craniocerebral MRI there is obvious atrophy in AD patients’ hippocampal atrophy heir atrophy VD patients also have hippocampal atrophy to a certain extent,it is lower than AD,AD patie(P< 0.01 ),compared with these,AD patients’ temporal angle is obviously deeper than VD patients’ (P< 0.05 ),it is the indirect evidence of hippocampal atrophy. The decrease of MMSE score on VD patients’ were positively correlated with the frontal and temporal lobes It is shown from craniocerebral MRI determination for VD patients,patients with frequently ecountered focus and single focus,both sides focus and single focus,total area of focus larger than 50mm^3and smaller than 50mm^3,their congnitive function determination is reduced remarkably. Conclusion VD and AD have the different features,the difference between VD and AD is decided by its pathologic change property,location and pathological physiological mechanism.

关 键 词：血管性痴呆 阿尔茨海默病 认知障碍 头部MRI 

分 类 号：R749.1[医药卫生—神经病学与精神病学]