遗忘型轻度认知损害和非痴呆血管性认知损害的局部脑血流量  

Research on regional cerebral blood flow in patients of amnestic mild cognitive impairment and vascular cognitive impairment-no dementia

作　　者：袁晶[1] 付建辉[1] 郭起浩[1] 洪震[1] 

机构地区：[1]复旦大学附属华山医院神经内科,上海200040

出　　处：《中华神经科杂志》2008年第10期678-682,共5页Chinese Journal of Neurology

基　　金：国家自然科学基金资助项目（30570601）

摘　　要：目的探讨遗忘型轻度认知损害（aMCI）和非痴呆血管性认知损害（VCI-ND）的局部脑血流量（rCBF）改变的特征。方法健康中老年人16名，aMCI组患者10例，VCI-ND组患者12例，年龄在50～80岁，教育程度均在初中毕业及以上，全部完成头颅CT或MRI检查。应用Xe—CT技术定量测定38例研究对象脑不同部位的rCBF。结果（1）静息状态健康中老年人（NC）组脑不同部位的rCBF分布情况：由高到低分别为基底节核团（76．4±8．6）ml·100g^-1·min^-1、皮质（48．0±7．1）ml·100g^-1·min^-1和白质（20．5±1．7）ml·100g^-1·min^-1。（2）Nc组、aMCI组和VCI—ND组患者的rCBF表现比较：aMCI组颞、顶、枕叶的rCBF值呈一定趋势的减少，VCI—ND组额叶的rCBF值呈一定趋势的减少，而VCI-ND组rCBF下降最明显的部位集中在白质区域[（17．7±2．3）ml·100g^-1·min^-1，F=5．740，P=0．002]，从深度看覆盖了脑室旁白质和皮质下深部白质两部分，从长度看覆盖了白质的前后区域。3组基底节区核团包括尾状核、豆状核和丘脑的rCBF值比较差异无统计学意义。结论aMCI和VCI—ND的rCBF值的差异反映了两者在病理机制方面的差异。Objective To investigate the regional cerebral blood flow （rCBF） in amnestic mild cognitive impairment （aMCI）and vascular cognitive impairment-no dementia （VCI-ND） subjects. Methods Sixteen normal elders, 10 patients of aMCI, 12 patients of VCI-ND who were aged from 50 to 80 years old and received an education of middle school or higher. All participants finished cranial CT or MRI. Xe-CT was used to evaluate rCBF of different cerebral regions of all participants. Results The distribution of rCBF of basal ganglia, the cortex and white matter was （ 76. 4 ± 8.6 ）, （48. 0 ±7. 1 ） and （ 20. 5 ± 1.7 ） ml·100g^-1·min^-1, respectively. When compared in 3 groups, the temporal and parietal lobe rCBF had a decreasing tendency in aMCI group, while in VCI-ND group, the most dominant decreasing parts were mainly concentrated in white matter region （ （ 17.7 ± 2. 3 ） ml·100g^-1·min^-1, F = 5. 740, P = 0. 002 ）. Whatever the depth or the width was, both periventrieular and subcortical deep white matter, anterior and posterior ventricular regions were all involved. There are no dominant difference of rCBF in caudate nucleus, lenfiform nucleus and thalamus. Condusion The difference in rCBF reflects the pathological difference between aMCI and VCI-ND.

关 键 词：认知障碍 记忆障碍 脑血管意外 局部血流 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]