轻度认知功能障碍患者正电子发射计算机体层摄影术和神经心理学测定的初步研究  

A study of positron emission tomography and neuropsychological test in the patients with mild cognitive impairment

作　　者：曹秋云[1] 江开达[1] 刘永昌 肖世富[3] 张明园[3] 黄红芳[3] 左传涛 

机构地区：[1]复旦大学附属华山医院精神医学教研室,上海200030 [2]复旦大学附属华山医院核医学科,上海200030 [3]上海市精神卫生中心

出　　处：《中华精神科杂志》2002年第1期2-6,共5页Chinese Journal of Psychiatry

基　　金：上海市医学领先专业老年重点学科建设基金资助项目 ( 95 -Ⅲ -011)

摘　　要：目的　探讨轻度认知功能障碍患者脑葡萄糖代谢与神经心理学特点及其相互关系。方法　采用正电子发射体层摄影术 (PET)、简易智能状态测定 (MMSE)、韦克斯勒记忆量表测定 (WMS)和总体衰退量表 (GDS)测定 10例轻度认知功能障碍 (MCI)患者和 10名健康志愿者 (HC)。结果 (1)MCI组MMSE[(2 4.6± 2 2 )分 ]、WMS[(6 9.4± 10 .4)分 ]分值低于HC组 [分别为 (2 8.9± 1.1)分和 (93.1± 9.0 )分 ;P〈0 .0 1];(2 )MCI组左侧眶回、右侧颞叶中回和右侧壳核的局部脑葡萄糖代谢率 (rCMRglc)较HC组低 (P〈0 .0 5～ 0 .0 1) ;(3)将年龄、受教育年限、MMSE、WMS与不同脑区用18F标记的脱氧葡萄糖放射性比值进行相关分析显示 ,与年龄呈负相关 (P〈0 .0 5或P〈0 .0 1)的脑区有 :眶回、左侧额上回、左侧额下回、颞叶中回、颞叶下回、左侧顶叶、左侧中央前回、右侧中央后回、左颞叶内侧皮质、左侧海马回、左侧海马旁回、右侧前扣带回、后扣带回、左侧杏仁核等。与文化程度呈正相关 (P〈0 .0 5或P〈0 .0 1)的脑区有 :左侧颞叶下回、中央前回、左侧中央后回等 ;而右侧壳核则呈负相关。与MMSE呈正相关 (P〈0 .0 5或P〈0 .0 1)的脑区有 :额下回、左侧颞叶上回、颞叶中回、颞叶下回、左侧顶叶、左侧中央前回、中央后回、颞叶内侧皮?Objective To study the features of regional cerebral metabolism rate of glucose in patients with mild cognitive impairment (MCI) by positron emission tomography (PET) and their relationships with neuropsychological tests. Method The PET.Mini-Mental State Examination (MMSE),Wechsler Memory Scale (WMS) and global deterioration scale(GDS) were conducted in 10 patients with MCI and 10 health volunteers as controls (HC).Results (1)The scores of MMSE and WMS in the MCI patients were lower than that in HC(P<0.01).(2)The regional cerebral metabolism rate of glucose (rCMRglc) in the left orbital gyrus,right middle temporal gyrus and right putamen was lower in MCI group than that in HC group (P<0.05-0.01).(3)The rCMRglc in orbital gyrus,putamen,left hippocampus and parahippocampal gyrus,cingulate gyrus,left amygdaloid body,precentral gyrus,postcentral gyrus and medial occipitotemporal gyrus was negatively correlated with age,while it was positively correlated with MMSE score in left putamen,temporal lobe,anterior cingulate gyrus,left insular lobe,amygdaloid body,precentral gyrus,postcentral gyrus and medial occipitotemporal gyrus,and it was correlated positively with WMS score in left putamen,temporal lobe,left insular lobe,precentral gyrus and postcentral gyrus,and correlated positively with education in right putamen,right inferior temporal gyrus,precentral gyrus,left poscentral gyrus. Conclusion The rCMRglc is lowered in MCI patients and correlated with the cognitive impairment severity,age,and education.

关 键 词：痴呆 认知障碍 体层摄影术 发射型计算机 脱氧葡萄糖 病因 神经心理学测验 

分 类 号：R749.04[医药卫生—神经病学与精神病学]