阿尔茨海默病的脑血流灌注研究  

The cerebral blood perfusion research on Alzheimer disease

作　　者：高凤莲[1] 秦绍森[2] 

机构地区：[1]首都医科大学附属北京世纪坛医院神经内科,100038 [2]卫生部北京医院神经内科,100730

出　　处：《中国神经免疫学和神经病学杂志》2012年第4期288-291,共4页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的探讨AD患者脑血流灌注的特征性变化。方法选择20例确诊AD患者和10例认知正常者,对所有入组对象行SPECT脑血流灌注显像检查,对所得图像进行视觉分析和半定量分析,比较两组对象各脑区血流灌注情况的差异,并比较AD患者左、右脑叶脑血流灌注的差异。结果 (1)视觉分析结果显示,AD组以颞叶或顶叶脑血流灌注减低为主,各占55%,其中双侧颞顶叶血流灌注减低者占15%,单侧颞顶叶血流灌注减低占20%。正常认知组SPECT影像学表现各异,额叶、颞叶、顶叶、枕叶、丘脑、基底节血流灌注减少情况均存在,各占10%。但无双侧颞顶叶血流灌注减少者,40%表现完全正常。(2)半定量分析结果显示,AD组在右额叶、双侧颞顶叶、右枕叶血流灌注显著低于正常认知组(P<0.05),以右侧颞叶血流灌注降低最明显,左右颞顶叶血流低灌注程度对比无显著性差异。结论 AD患者的SPECT特征性表现为双侧对称性颞顶叶血流低灌注,其中右侧颞叶血流灌注下降最严重。Objective To investigate the characteristic changes of regional cerebral blood flow （CBF） in patients with Alzheimer disease （AD）. Methods 20 AD patients and 10 cognitive normal aging cases were chosen, SPECT was adopted among all the subjects. Visual evaluation and semi-quantitative analysis of the images were accomplished, the CBF in each brain lobe between the two groups, and between left and right lobes in the AD group was compared. Results （1） Visual evaluation： hypoperfusion was shown at temporal lobe or parietal lobe both in 55% AD patients. Among them, 15% showed hypoperfusion at bilateral temporoparietal lobes, and 20% unilateral temporoparietal lobe . In the cognitive normal group, the location of hypoperfusion was various, including frontal lobe, temporal lobe, occipital lobe, thalamus, and basal ganglia, with 10% control cases on each location. No bilateral temporoparietal hypoperfusion or unilateral temporopariental hypoperfusion was found in control cases. 40% of them showed normal. （2） Semi-quantitative analysis： Compared with normal aging cases, the r-CBF of several regions in the AD patients decreased significantly （P〈0.05）, including the right frontal lobe, the bilateral temporal lobes, the bilateral parietal lobes, and the right occipital lobe. The decrease in right temporal lobe was the most remarkable. There were no significant differences between the left and the right temporoparietal lobe in AD patients. Conclusions The typical change of SPECT in AD is hypoperfusion in bilateral temporoparietal lobes symmetrically, with predominant change in the right temporal lobe.

关 键 词：阿尔茨海默病 体层摄影术 发射型计算机 单光子 脑血流灌注 

分 类 号：R743.9[医药卫生—神经病学与精神病学]