阿尔茨海默病与轻度认知功能障碍病人脑正电子发射计算机断层扫描的对照研究  

The comparison of the regional cerebral metabolism rate of glucose in Alzheimer′s disease with mild cognitive impairment

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

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：《中华医学杂志》2002年第23期1613-1616,共4页National Medical Journal of China

基　　金：上海市医学领先专业老年精神病学重点学科项目资助 ( 95-Ⅲ-0 11)

摘　　要：目的　通过对Alzheimer病 (AD)与轻度认知功能障碍 (MCI)病人的脑葡萄糖代谢的对照研究 ,以期探讨MCI与AD之间的关系。方法　对符合入组标准的 13例AD病人、10例MCI病人和 10名健康志愿者 (HC)进行正电子发射计算机断层扫描 (PET)检查测定。结果　 (1)健康老人可出现顶叶、颞叶葡萄糖代谢减低 ,但程度较轻 ;MCI病人顶叶葡萄糖代谢进一步减低 ,痴呆组顶叶、颞叶和额叶葡萄糖代谢减低更为明显。 (2 )AD组的额叶 (包括额叶上、中、下回 ,眶回和直回 )、颞叶 (包括颞叶上、中、下回 )、顶叶 (包括顶上小叶、缘上回、角回 )、边缘系统 (包括扣带回前部、岛叶 )、基底节 (包括丘脑、尾状核、杏仁核 )等脑区局部脑葡萄糖代谢率 (rCMRglc)减退较明显 ,与MCI组和健康对照组相比 ,差异具有显著意义 (P <0 0 5～P <0 0 0 1)。 (3)MCI组在额叶、颞叶、顶叶、边缘系统、基底节等脑区rCMRglc均值与正常对照组相比都有所减低 ,但其差异多数无显著意义 (P >0 0 5 ) ;提示MCI上述脑区的功能状态处于正常老人与AD病人之间。只有在左侧尾状核rCMRglc减退较明显 ,与正常对照组相比 ,差异有显著意义 (P <0 0 5 )。结论　AD病人的额叶、颞叶、顶叶、边缘系统、基底节等部位的脑葡萄糖代谢均有减低 。Objective To study the feature of regional cerebral metabolism rate of glucose (rCMRglc) of Alzheimer′s disease (AD) and mild cognitive impairment (MCI) by positron emission tomography (PET) and the relationship between MCI and AD. Methods 13 AD patients, 10 MCI patients and 10 health volunteers as a control group (HC) were underwent 18F-fluoro deoxyglucose (18F-FDG)-PET scanning. Results (1) There was lightly decreasing of radioactivity of temporal lobe and parietal lobe in HC group, a little severer decrease in MCI group, markedly decrease of radioactivity of temporal lobe, parietal lobe and frontal lobe in AD group examined by naked-eye. (2) The rCMRglc of many parts of brain such as frontal lobe, including superior, middle and inferior frontal gyrus, orbital gyrus and rectus gyrus, temporal lobe, including superior, middle and inferior temporal gyrus, parietal lobe, including superior parietal lobe, supramarginal gyrus and angular gyrus, limbic system, including anterior cingulate gyrus, insular lobe, basal ganglions, including thalamus, caudate nucleus and amygdaloid nucleus decreased significantly in AD group, compared to MCI and HC groups (p<0.05～p<0.001). (3) The rCMRglc of many parts of brain such as frontal lobe, temporal lobe, parietal lobe, limbic system, and basal ganglions in MCI group was lower than that in HC group, but not significantly (p>0.05). Only that of the left caudate ucleus in MCI decreased significantly compared to that in HC group (p<0.05). Conclusion Decreasing of rCMRglc of parietal lobe is sensitive in evaluating cognitive function, next one is temporal lobe, and then frontal lobe. The rCMRglc of frontal lobe, temporal lobe, parietal lobe, limbic system, and basal ganglions decreasing markedly indicates that global function decayed in AD patients. While the rCMRglc of those parts in MCI patients′ brain decreases mildly. This indicates that MCI is the middle state of AD and HC. Decreasing of rCMRglc of the left caudate nucleus has a certain role in diagnosis of MCI.

关 键 词：诊断 阿尔茨海默病 认知功能障碍 正电子发射计算机断层扫描 

分 类 号：R749.1[医药卫生—神经病学与精神病学]