PET脑显像和脑脊液检测对临床痴呆诊断再评估的意义  

Meaning of re-evaluation for clinical dementia diagnosis by brain PET imaging and CSF test

作　　者：王治国[1] 张宗鹏[1] 吴锐先[1] 战莹[1] 武晓丹[1] 张国旭[1] 

机构地区：[1]沈阳军区总医院核医学科,110016

出　　处：《神经疾病与精神卫生》2017年第7期478-482,共5页Journal of Neuroscience and Mental Health

基　　金：辽宁省自然科学基金资助项目（20140220066,20170540927）

摘　　要：目的对首次临床诊断的痴呆患者进行再评估，寻找更适合的诊断方法与标准。方法选择2011年6月～2012年6月共22例轻度神经退行性非血管性痴呆患者进行脑匹兹堡复合物B（PIB）-PET、脱氧葡萄糖（FDG）-PET、脑脊液检测和神经心理学测试，每隔1～2年进行一次简易智力状态量表（MMSE）评分，随访至2017年4月。结果22例受试者中7例的痴呆诊断发生了改变。其中有4例阿尔茨海默病转变为路易体痴呆；2例阿尔茨海默病和1例行为变异型额颞叶痴呆转变为不定型痴呆。诊断有变化组和无变化组的教育程度、AB42浓度、理解能力测试、情景记忆测试及顶叶脑葡萄糖代谢减低程度差异有统计学意义（P〈0．05）。结论PET脑显像和脑脊液检测对临床痴呆诊断再评估具有指导意义。Objective To find better diagnostic methods and criteria by re-evaluation for initial clinical dementia diagnosis. Methods Totals of 22 subjects diagnosed as mild neurodegenerative non-vascular dementia from June 2011 to June 2012 were included. Brain PIB and FDG PET, CSF test and neuropsychological tests were assessed in all patients. MMSE test was measured every 1-2 years untill April 2017. Results The diagnosis of 7 out of 22 subjects was changed. 4 patients diagnosed with Alzheimer disease （AD） changed to dementia with Lewy bodies （DLB）, while 2 AD patients and 1 behavioural variant frontotemporal dementia （bvFTD） patient changed to unspecified dementia （UNS）. There were significant differences between changed and non-changed team in educational level, A [3 42 concentration, comprehension test, episodic memory test and reductions in regional cerebral glucose metabolism （P 〈 0.05）. Conclusions Brain PET imaging and CSF test have guiding significance for re-evaluation for clinical dementia diagnosis.

关 键 词：痴呆 脱氧葡萄糖 匹兹堡化合物B 正电子发射断层扫描 脑脊液 

分 类 号：R74[医药卫生—神经病学与精神病学]