PET和TCD对阿耳茨海默病早期诊断的研究  

A study on early diagnosis of Alzheimer's disease using PET and TCD

作　　者：贾建平[1] 贾健民[2] Martin Ploock 

机构地区：[1]北京宣武医院神经内科,北京100053 [2]河北省邯郸市第一医院,河北邯郸056002 [3]新西兰Otago大学医学院神经内科

出　　处：《中风与神经疾病杂志》2000年第5期272-274,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的　利用正电子发射计算机断层扫描 (positron emission tomography,PET)和经颅多普勒超声(transcranial doppler,TCD)相结合的方法探讨阿耳茨海默病 (Alzheimer's disease,AD)的早期诊断 ,以及 AD与脑血液供应之间的关系。方法　 2 0例可疑 AD患者和 2 0例正常对照行 PET、TCD以及临床神经心理量表检查 ,对局部脑区葡萄糖代谢率 (regional cerebral metabolic rate of glucose,r CMRGlc)、大脑中动脉血流速度 (middle cere-bral artery flow velocity,MCAFV)和认知障碍之间进行相关性分析。结果 AD患者双侧 r CMRGlc和双侧MCAFV均呈不对称性降低 ,并与 AD早期认知障碍不对称性吻合。皮层额顶颞 (frontotem poroparietal,FTP)区的代谢、MCAFV、以及神经心理不对称指数之间具有密切相关关系。结论　 (1) AD病人早期阶段已发生了代谢和血流变化。血流速度的减低是由于代谢的减低而引起的。 (2 )对这些代谢和血流变化的研究不仅找出了 AD早期诊断敏感指标 ,而且也探明了 AD与缺血之间的关系。 (3) PET和 TCD是早期诊断 AD的有效手段 ,尤其是 TCD简便易行 ,能通过检测血流降低来推测 AD患者的早期代谢变化。Objective To explore the usefulness of a combination of positron emission tomography (PET) and transcranial doppler (TCD)for early diagnosis of Alzheimer's disease (AD), and to explore the relationship between AD and cerebral blood supply. Methods Twenty mild AD patients and 20 healthy controls subjected to Mini Mental State Examination (MMSE), TCD and PET examinations. Correlation analysis was undertaken between these results. Results AD patients show a bilaterally asymmetric reduction of middle cerebral artery flow velocity (MCAFV) and regional cerebral metabolic rate of glucose (rCMRGlc), where the reduced rCMRGlc side is right at the reduced MCAFV side. These changes in rCMRGlc and MCAFV coincide AD congnitive impairment. There was a positive significant correlation between frontotemporoparietal (FTP)metabolic, MCAFV, and cognitive asymmetry indexes. Conclusion (1)AD patients in early stage have a reduction of rCMRGlc and MCAFV with a pattern of asymmetry, and the slowness of MCAFV is due to the reduction of rCMRGlc. (2)These findings could be used not only as indexes to diagnose early AD, but also as evidences to analyze the relationship between AD and ischaemia. (3) PET and TCD are powerful tools for AD early diagnosis, especially the TCD is a simple and economic examination by which the reduction of rCMRGlc is inferred through evaluation of changes in MCAFV.

关 键 词：阿耳茨海默病 PET TCD 早期诊断 

分 类 号：R749.160.4[医药卫生—神经病学与精神病学]