轻度认知功能障碍的神经心理学和脑血流灌注研究  

Nouropsychological and cerebral blood perfusion studies of mild cognitive impairment.

作　　者：昂秋青[1] 肖世富[1] 姚培芬[1] 江开达[1] 张明园[1] 金少津 林祥通[1] 王红芳 刘福根[1] 张选红[1] 江学锋 高之旭[1] 

机构地区：[1]上海市精神卫生中心,200030

出　　处：《中国神经精神疾病杂志》2000年第6期330-333,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的　用神经心理学和脑血流灌注检查探讨轻度认知功能障碍 (MCI)特点 ,分析其与阿尔茨海默病 (AD)和健康衰老的差异。方法　对 2 1例MCI ,18例AD和 19例健康老人进行简易智力状态检查 (MMSE) ,日常生活能力量表(ADL)和总体衰退量表 (GDS)评定 ,韦克斯勒记忆测验 (WMS)及SPECT检查。SPECT结果作半定量分析 (以放射性计数比值 -RAR表示 )。结果　认知功能评定结果 :与健康老人相比 ,MCI除ADL成绩外 ,其余均显著降低 ;与AD相比 ,MMSE、ADL、GDS以及WMS中的短时记忆和语言记忆成绩均显著优于AD(P <0 0 5 )。脑血流灌注比较结果 :MCI组与健康老人各部位的RAR无差异 ;与AD组相比 ,扣带回、左基底节、左枕叶、右颞上回、双侧额叶、双侧颞下回和双侧顶叶RAR均显著增高 (P <0 0 5 )。以顶叶RAR为变量作聚类分析产生两类MCI(MCI 4和MCI 16) ,MCI 16在左丘脑的血流灌注低于健康老人(P <0 0 1) ,在双侧颞下回和右颞上回高于AD(P <0 0 1)。结论　MCI为一组异质性疾病 ,认知功能缺损和脑血流灌注的改变均存在多种类型。顶叶能对MCI进行有效分类。Objective To investigate the characteristics of mild cognitive impairment (MCI) with Neuropsychological evaluation and cerebral blood perfusion imaging and to compare its difference between Alzheimers disease (AD) and healthy elderly. Methods MMSE, ALD, GDA, WMS and SPECT were conducted in 21 MCI, 18 AD and 19 healthy elderly. Results MCI achieved significantly lower scores than healthy elderly in all cognitive function measures except ADL performance. MCI achieved significantly higher scores than AD in MMSE, ADL, GDS as well as short time memory and language memory in WMS ( P<0.05 ). Comparison of cerebral blood perfusion showed that there was no difference in RAR between MCI and healthy elderly in all brain areas. However, MCI showed significant higher perfusion at cingulate, left basal ganglia, left occipital lobe, right supra temportal gyrus, bilateral frontal lobes, bilateral infra temporal gyri, bilateral parietal lobes ( P<0.05 ). Hierarchial cluster analysis using parietal RAR as variable produced two categories of MCI (MCI 4 and MCI 16). MCI 16 showed significantly lower perfusion than healthy elderly at left thalamus ( P<0.01 ) and significantly higher perfusion that AD at bilateral infra temporal gyri( P<0.01 ). Conclusions MCI was identified as heterogeneous in terms of multiple subtypes in both cognitive function impairment and cerebral blood perfusion. Parietal lobes was postulated to be able to categorize MCI effectively.

关 键 词：神经心理学 轻度认知功能障碍 AD 脑血流灌注 

分 类 号：R741.02[医药卫生—神经病学与精神病学]