阿尔茨海默病患者的脑干、尾状核、壳核体积变化特点及相关性分析  

The Characteristics and Correlation Analysis of the Volume Changes of Brainstem,Caudate Nucleus and Putamen in Patients with Alzheimer’s Disease

作　　者：王晓[1] 刘金岭 王栋[2] WANG Xiao;LIU Jin-ling;WANG Dong(Department of Radiology,the Affiliated Nanyang Second General Hospital,Xinxiang Medical University,Nanyang 473012,China;Department of Neurosurgery,the Affiliated Nanyang Second General Hospital,Xinxiang Medical University,Nanyang 473012,China)

机构地区：[1]新乡医学院附属南阳市第二人民医院影像科,南阳市473012 [2]新乡医学院附属南阳市第二人民医院神经外科,南阳市473012

出　　处：《中国临床神经科学》2020年第6期611-617,共7页Chinese Journal of Clinical Neurosciences

基　　金：国家重点研发计划项目(编号:2017YFC0111900);河南省医学科技攻关计划联合共建项目(编号:LHGJ20191469)。

摘　　要：目的探讨阿尔茨海默病(AD)患者的脑干、尾状核、壳核体积变化特点及其相关性。方法前瞻性选取2017年3月至2018年6月收治的29例早期AD患者为AD组,29例轻度认知损害(MCI)患者为MCI组,29例健康志愿者为对照组。使用自制的调查问卷收集受试者的一般情况,简易精神状态量表(MMSE)评估认知功能;采用1.5T磁共振诊断系统和FreeSurfer图像处理和分析软件,测算随访前、随访2年后受试者的脑干、尾状核、壳核、皮质、海马、颞叶和全脑体积变化。结果MMSE量表评分:AD组明显低于MCI组和对照组(P<0.05),MCI组明显低于对照组(P<0.05)。随访2年后MCI组和AD组的脑干、尾状核、壳核体积均较随访前明显缩小(均P<0.01);随访前对照组的脑干、尾状核、壳核体积与随访2年后比较,差异无统计学意义(P>0.05)。随访前和随访2年后,3组的脑干、尾状核、壳核体积比较,差异均有统计学意义(P<0.01),其中AD组较MCI组和对照组降低,MCI组较对照组降低。Pearson相关性分析显示,MCI组脑干与尾状核、壳核体积间无明显相关性;AD组脑干与尾状核、壳核体积间呈正相关性。多因素Logistic回归分析示脑干、尾状核、壳核萎缩是全脑萎缩的独立影响因素。结论AD患者脑干、尾状核、壳核体积进行性缩小,且脑干体积与尾状核、壳核体积变化呈正相关,上述体积变化测定有利于AD的早期诊断和干预。Aim To investigate the characteristics and correlation of the volume changes of brainstem,caudate nucleus and putamen in patients with Alzheimer’s disease(AD).Methods A prospective selection of 29 patients with early AD admitted to our hospital from March 2017 to June 2018 were included in AD group,29 patients with mild cognitive impairment(MCI)were divided into MCI group,29 cases healthy volunteers served as normal control group.A self-made questionnaire was used to collect the general conditions of the subjects,and the Mini-mental State Scale(MMSE)was used to assess cognitive function;1.5 T magnetic resonance diagnostic system and FreeSurfer image processing and analysis software were used to calculate the patients,health before and after 2 years of followup.The brain stem,caudate nucleus,putamen,cortex,hippocampus,temporal lobe and whole brain volume were measured before and after 2 years of follow-up.Results MMSE score of AD group was significantly lower than that of MCI group and the normal control group(P<0.05),while MMSE score of MCI group was significantly lower than that of the control group(P<0.05).After two years of follow-up,the brainstem,caudate nucleus,and putamen of MCI group and AD group were significantly smaller than before(P<0.01).The brainstem,caudate nucleus and putamen volume of the normal control group were not statistically different before and after two years of follow-up(P>0.05).The brainstem,caudate nucleus,and putamen volume were statistically significant among the three groups before and after the followup for two years(P<0.01).AD group was lower than MCI group and the control group,MCI group was lower than the control group.Pearson correlation analysis showed that there was no significant correlation between brainstem volume and caudate and putamen volume in patients with mild cognitive impairment and MCI.There is a positive correlation between the volume of nucleus and putamen.Multivariate Logistic regression analysis showed that the atrophy of brainstem,caudate nucleus and putame

关 键 词：阿尔茨海默病 脑干 尾状核 壳核 磁共振成像 

分 类 号：R749.1[医药卫生—神经病学与精神病学]