老年认知功能障碍与脑结构CT测量的相关性研究  

Correlative Study between the Elder Cognitive Damage and CT Measurement of Brain Configuration

作　　者：王瑞[1] 郭庆乐[1] 元小冬[2] 赵静[1] 郑宝霞[1] 刘景旺[1] 赵文忠[1] 韩义[1] 刘淑娟[1] 李健[1] 王振常[3] 

机构地区：[1]华北煤炭医学院附属开滦医院CT室,河北唐山063000 [2]华北煤炭医学院附属开滦医院神经内科,河北唐山063000 [3]首都医科大学附属同仁医院放射科

出　　处：《实用放射学杂志》2007年第3期289-292,共4页Journal of Practical Radiology

摘　　要：目的探讨脑萎缩与老年认知功能障碍之间的相关性。方法对开滦集团公司1063名离退休职工进行健康查体,用简易精神状态量表(MMSE)评定认知功能,按分界值将本次研究对象分为认知功能障碍组和认知功能正常组,同时用CT线性测量脑的相关部位以诊断脑萎缩情况,并对各型脑萎缩与认知功能的相关系数及提示老年认知功能障碍的敏感度、特异度、准确度进行分析。结果1063名观察对象中符合入选标准并资料完整者共计511名,其中108名有认知功能障碍,髓质脑萎缩55名、皮质萎缩5名、混合型萎缩30名;认知功能正常者403名,髓质脑萎缩214名、皮质萎缩13名、混合型萎缩62名。认知功能障碍组脑萎缩的发病率高于认知功能正常组,差异具有统计学意义(P<0.005);2组间颞叶海马钩回间距(26.86mm±3.73mmvs25.95mm±3.80mm)及海马钩回间距/大脑左右径的比值(0.21±0.02vs0.20±0.02)差异具有统计学意义(P<0.05);海马钩回间距、皮质脑萎缩、混合型脑萎缩与认知功能障碍呈负相关(分别为r=-0.094,P=0.034,r=-0.156,P≈0.000,r=-0.147,P≈0.000),以海马钩回间距20mm提示老年认知功能障碍的敏感度最高(98.14%),混合型脑萎缩的特异度(84.86%)、准确度最高(72.80%)。结论CT测量相关脑结构,判断脑萎缩类型可以为老年认知功能障碍的诊断提供有价值的信息。Objective To assess the correlation between the older cognitive impairment and brain atrophy. Methods A total 1063 cases were sampled from the retired workers of kailuan Coal Mine and surveyed with questionnaires . The cognitive function was assessed by Mini - Mental State Examination （ MMSE ） , two groups （ cognitive damage and normal cognitive function ） were separated according to the scrods. The linear measurement of relative brain configuration was performed with CT based technique and corresponding index calculated in order to diagnose brain atrophy. Further, the correlation between the types of brain atrophy and the cognitive damage as well as the coefficient, sensitivity, specificity and accuracy of prompt the cognitive damage were analysed. Results Of 1063 cases,511 cases were suitable for the standard in this study. Of them, 108 cases had cognitive damage, including medulla atrophy in 55 cases, cortex atrophy in 5 cases, mixed atrophy in 30 cases. 403 cases had normal cognitive functlon,ln this group, medulla atrophy in 214 cases, cortex atrophy in 13 ,mixed atrophy in 62 cases were found. The incidence of brain atrophy in the cognitive damage group was higher than that in normal cognitive function group, and there was significant difference （ P 〈 0. 005 ）. The interuncal distance （ 26.86 mm ＋ 3.73 mm vs 25.95 mm ＋ 3.80 mm ） and interuncal distance/intracranial width （0.21 ＋ 0.02 vs 0.20 ＋ 0.02 ） were significantly different between the cognitive damage group and the normal cognitive function group （P 〈 0.05 ）. Negative correlation was presented between interuncal distance, cortex atrophy, mixed atrophy and cognitive damage. The sensitivity of interuncal distance 20mm（ 98.14% ） , the specificity and accuracy of the mixed typed of brain atrophy （ 84.86% and 72.80% , respectively ） were the highest. Conclusion CT linear measurement of the relative brain configuratlon can offer to some diagnostic valae for cognitive damage in elder.

关 键 词：脑 认知功能 脑萎缩 体层摄影术 X线计算机 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]