血管性轻度认知障碍及非痴呆性血管性认知障碍患者局部脑血流量的临床研究  

Clinical research on regional cerebral blood flow in patients with vascular-mild cognitive impairment and vascular cognitive impairment-no dementia

作　　者：韩彦青[1] 梅元武[1] 李光来[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院神经内科,武汉430022 [2]山西医科大学第二临床医学院神经内科

出　　处：《山西医科大学学报》2009年第3期271-274,F0003,共5页Journal of Shanxi Medical University

基　　金：山西省卫生厅科技攻关计划基金资助项目(200609)

摘　　要：目的评价血管性轻度认知功能障碍(V-MCI)和非痴呆性血管性认知障碍(VCI-ND)患者局部脑血流量的变化特点,探讨局部脑缺血程度与血管性认知功能障碍严重程度的相关性。方法对22例V-MCI患者,18例VCI-ND患者及年龄,性别匹配的24例正常老年人应用单光子发射断层扫描(SPECT)对局部脑血流量进行定量分析,并对局部脑血流量与简易智能状态量表(MMSE)评分进行相关分析。结果SPECT显示:V-MCI组,VCI-ND组与对照组相比均有认知相关部位的血流灌注减低,差异有统计学意义(P<0.05)。VCI-ND组与V-MCI组相比额叶、颞叶、基底节和顶叶局部脑血流灌注均减少(P<0.05),并且均以额叶、颞叶血流灌注减少最为显著(P<0.01);VCI-ND组额叶、颞叶血流灌注减低与MMSE评分间存在正相关关系(P额<0.01及P颞<0.05)。结论血管性认知功能障碍(VCI)患者在未达到痴呆之前已有认知相关部位脑血流量的降低,即使对V-MCI组SPECT也同样敏感。SPECT定量分析脑血流量对于VCI的预测、早期诊断及治疗都有重要意义。Objective To access the features of regional cerebral blood flow（rCBF）in patients with vascular mild cognitive impairment（V-MCI）and vascular cognitive impairment-no dementia（VCI-ND）,and to explore the correlation between cerebral regional blood flow with degree of cognitive impairment. Methods The rCBF was quantitatively determined using SPECT 99Tcm-ECD in V-MCI group（n=22）,VCIND group（n=18）and normal control（NC）group（n=24）.The features of rCBF were analyzed by quantity technique.The relation between rCBF and mini mental state examination（MMSE）score was analyzed. Results The rCBF at frontal,temporal,parietal cortex and basal ganglia in V-MCI group and VCI-ND group was lower than that in NC group（P〈0.05）.The rCBF at the same brain cortex and basal ganglia in VCI-ND group was significantly lower than that in V-MCI group and NC group（P〈0.05）,especially in frontal and temporal cortex（P〈0.01）.The positive correlation was found between rCBF of frontal and temporal cortex and MMSE in VCI-ND group（P〈0.01 and P〈0.05）. Conclusion The rCBF of VCI patients showed a decreasing tendency before dementia.Even it is sensitive to V-MCI.The quantitative detection of rCBF by SPECT might play an important role in prediction,diagnosis and treatment of VCI.

关 键 词：血管性认知功能障碍 局部脑血流 单光子发射断层扫描 

分 类 号：R741[医药卫生—神经病学与精神病学]