MRI测量的海马、内嗅皮质体积与轻度认知障碍相关性的临床研究  

A clilical correlative study of hippocampal and entorhnal cortex volume measured with MRI and mild cognitive impairment

作　　者：鲍娟[1] 吴英[2] 谈跃[1] 赵晓红[1] 王曦[1] 

机构地区：[1]昆明医学院第二附属医院老年病科,650101 [2]昆明医学院第二附属医院康复科,650101

出　　处：《国际脑血管病杂志》2010年第3期204-210,共7页International Journal of Cerebrovascular Diseases

基　　金：云南省应用基础研究面上项目联合专项基金（2009CD171）

摘　　要：目的研究轻度认知障碍（mild cognitive impairment，MCI）与海马和内嗅皮质体积变化的相关性以及影响因素，探讨MRI测量海马和内嗅皮质体积鉴别MCI与认知功能正常（nornlal cognitive，NC）的价值。方法从体检者中人选MCI组21例，NC组18名，进行一般情况评定、实验室检查和神经心理量表评测。应用MRI测量海马和内嗅皮质体积，并分析其与记忆功能的相关性；非条件logistic回归分析海马和内嗅皮质体积诊断MCI的特异性和敏感性；多重线性回归分析海马和内嗅皮质体积的影响因素。结果MCI患者海马和内嗅皮质体积分别为（6．19±0．74）和（2．66±0．17）cm^3；显著小于NC组的（6．80±0．79）和（3．03±0．12）cm^3（P〈0．05）。海马体积与内嗅皮质体积显著相关（r=0．566，P〈0．001）；海马体积与临床记忆量表总分显著相关（r=0．430，P=0，04），内嗅皮质体积与临床记忆量表总分显著相关（r=0．722，P〈0．001）。应用海马体积区分MCI和NC的特异性为66．7％，敏感性为76．2％；应用内嗅皮质体积区分MCI和NC的特异性为88．9％，敏感性为90．5％。另外，海马体积与餐后2h血糖（P〈0．05）、收缩压（P〈0．05）、舒张压（P〈0．05）和血浆总胆固醇水平（P〈0．01）呈负相关，而内嗅皮质体积则与之无关。结论内嗅皮质和海马体积萎缩与记忆障碍密切相关，MRI测量的内嗅皮质和海马体积对MCI与NC的鉴别具有一定价值，而且内嗅皮质体积的特异性和敏感性优于海马体积。血压、血糖和血脂水平增高可能通过影响海马体积。Objective To investigate the correlation and influencing factors between mild cognitive impairment （MCI） and the changes of hippocampal and entorhinal cortex volume and to evaluate the value of using MRI volumetric measurement of hippocampus and entorhinal cortex to identify MCI and normal cognition （NC）. Methods Twenty-one subjects selected from physical examinations were divided into an MCI group and 18 subjects were divided into an NC group. The general assessment, laboratory tests and neuropsychological scale evaluation were conducted. The MRI volumetric measurement of hippocampus and entorhinal cortex was used and its correlation with memory function was analyzed, The specificity and sensibility of diagnosing MCI of hippocampal and entorhinal cortex volume were analyzed by non-conditional Logistic regression. The influencing factors of hippocampal and entorhinal cortex volume were analyzed by multiple linear regressions. Results The hippocampal and entorhinal cortex volume in subjects with MCI was 6. 19 ± 0. 74 and 2.66 ± 0. 17 cm^3, respectively; they were significantly smaller than 6.80 ±0.79 and 3.03 ±0. 12 cm^3 in the NC group （P 〈0.05）. The hippocampal volume was significantly correlated with the entorhinal cortex volume （r = 0. 566, P 〈0. 001 ）; the hippocampal volume was significantly correlated with the total score of Clinical Memory Scale （r = 0. 430, P = 0. 04）, and the entorhinal cortex volume was significantly correlated with the total score of Clinical Memory Scale （r =0.722, P 〈0. 001）. The specificity and sensitivity of using hippocampal volume to differentiate MCI and NC were 66.7% and 76.2%, respectively. The specificity and sensitivity of using entorhinal cortex volume to differentiate MCI and NC were 88.9% and 90. 5%, respectively. In addition, There was a negative correlation between the hippocampal volume and 2 h postprandial blood glucose （P 〈 0.05）, systolic blood pressure （P 〈 0.05 ）, diastolic blood pressure （P 〈 0.05 ）, and plasma

关 键 词：认知障碍 海马 内嗅皮层 萎缩 磁共振成像 

分 类 号：R749.16[医药卫生—神经病学与精神病学]