轻度认知障碍患者的脑血流变化  

Changes of cerebral blood flow in patients with mild cognitive impairment

作　　者：闻红斌[1] 周宏斌[1] 

机构地区：[1]华中科技大学同济医学院附属襄樊医院神经内科,湖北省襄樊市441021

出　　处：《中国临床康复》2005年第37期6-7,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨经颅多普勒超声对轻度认知障碍患者的诊断价值。方法:选择2003-03/2004-10华中科技大学同济医学院附属襄樊医院收治的30例轻度认知障碍患者,以32例健康人为正常对照组。所有被试者行经颅多普勒超声检查,观察双侧大脑中动脉,大脑前动脉,大脑后动脉,双侧椎动脉,基底动脉血流速度;还进行神经心理学检测(包括简明精神状态评定量表,总体衰退量表和日常生活活动能力量表)。结果:按意向处理分析,62例被试者全部进入结果分析。①轻度认知障碍患者经颅多普勒超声异常情况:异常率为91﹪,其中颈内动脉系统异常率为56﹪,椎基底动脉系统异常率为52﹪。脑血流双侧下降18例,单侧下降8例,两侧不对称7例。②脑血流速度:轻度认知障碍患者大脑中动脉和基底动脉低于正常对照组[(43.6±8.9),(58.7±9.9)cm/s;(28.6±5.1),(38.7±8.1)cm/s,P<0.05]。③两者神经心理学评分无明显差异。结论:①轻度认知障碍患者已出现局部脑血流的下降,但并非全脑血流下降。②经颅多普勒超声对于轻度认知障碍患者的病因学研究及早期诊断及干预具有积极意义。AIM： To investigate the diagnostic value of transcranial Doppler ultrasound （TCD） in patients with mild cognitive impairment. METHODS： Thirty patients with mild cognitive impairment were selected from the Xiangfan Hospital affiliated to TongJi Medical College, Huazhong University of Science and Technology between March 2003 and October 2004, and 32 healthy people were taken as the normal control group. All the subjects were examined with TCD, the blood flow in bilateral middle cerebral arteries, anterior cerebral artery, posterior cerebral artery, bilateral vertebral arteries, and basilar artery were observed. They also received neuropsychological tests including mini-mental state examination （MMSE）, global diminution scale （GDS） and activities of daily living scale （ADL）. RESULTS： According to intention-to-treat analysis, all the 62 cases were involved in the analysis of results. ① Abnormality of TCD in the patients with mild cognitive impairment： The abnormal rate was 91%, including the abnormal rate in the internal carotid artery system was 56% and that in the vertebral basilar artery system was 52% respectively. The blood flow was decreased bilaterally in 18 cases, unilaterally in 8 cases, bilateral asymmetry in 7 cases. ② Cerebral blood flow velocity： The blood flow velocities in middle cerebral artery and basilar artery were lower in the patients with mild cognitive impairment than in the normal control group [（43.6±8.9）, （58.7±9.9） cm/s; （28.6±5.1）, （38.7±8.1） cm/s, P〈0.05]. ③There was no significant difference in the scores of neuropsychological tests between the two groups. CONCLUSION： ① Regional but not whole cerebral blood flow decreases in patients with mild cognitive impairment. ② TCD is of positive significance in the etiologieal study and the early diagnosis and iutervention in the patients with mild cognitive impairment.

关 键 词：认知障碍 血流速度 超声检查 多普勒 经颅 

分 类 号：R749.1[医药卫生—神经病学与精神病学]