MRI对老年性痴呆患者海马结构的评估及与认知功能的关系  

MRI evaluation of hippocampal structure in patients with Alzheimer’s disease and its relationship with cognitive function

作　　者：李成杰 欧文 刘伟 周兴宁 LI Chengjie;OU Wen;LIU Wei;ZHOU Xingning(Chengdu 363 Hospital Affiliated to Southwest Medical University,Chengdu 610041,China;Hospital of the People’s Government of Tibet Autonomous Region in Chengdu,Chengdu 610041,China)

机构地区：[1]西南医科大学附属成都三六三医院,四川成都610041 [2]西藏自治区人民政府驻成都办事处医院,四川成都610041

出　　处：《中国实用神经疾病杂志》2025年第3期277-283,共7页Chinese Journal of Practical Nervous Diseases

基　　金：四川省医学(青年创新)科研课题(编号:S20008)。

摘　　要：目的探究MRI对老年性痴呆(AD)患者海马结构的评估价值及相关参数与认知功能的关系。方法选取西南医科大学附属成都三六三医院的118例AD患者为研究组,另选取同期80例健康体检者为对照组,采用MRI对所有受试者海马区进行扫描,比较2组海马结构参数及MRI参数,采用蒙特利尔认知评估量表(MoCA)评估研究组患者认知状况,根据评分将患者分为认知正常组(n=75)和认知障碍组(n=43),比较2组海马结构参数、MRI参数,分析二者与认知功能的关系。结果研究组海马面积(HFA)、标准化海马面积(SHFA)、海马横径(HTD)、标准化海马横径(SHTD)均显著低于对照组(P<0.05),THW、STHW均显著高于对照组(P<0.05),2组海马矢径(HSD)、标准化海马矢径(SHSD)、外侧裂宽度(LFW)、标准化外侧裂宽度(SLFW)比较差异均无统计学意义(P>0.05)。研究组FA值显著低于对照组(P<0.05),ADC值显著高于对照组(P<0.05)。认知障碍组HFA、SHFA、HTD、SHTD均显著低于认知正常组(P<0.05),THW、STHW均显著高于认知正常组(P<0.05),2组HSD、SHSD、LFW、SLFW比较差异均无统计学意义(P>0.05)。认知障碍组FA值显著低于认知正常组(P<0.05),ADC值显著高于认知正常组(P<0.05)。Pearson相关系数分析显示,AD患者海马MRI参数SHFA、SHTD、FA值与MoCA、MMSE、ADL评分呈显著正相关(SHFA_(左侧)的r=0.381、0.373、0.370,SHFA_(右侧)的r=0.449、0.432、0.422,SHTD_(左侧)的r=0.446、0.427、0.408,SHTD_(右侧)的r=0.479、0.457、0.433,FA值的r=0.482、0.467、0.453,P<0.05),STHW、ADC值与MoCA、MMSE、ADL评分呈显著负相关(STHW_(左侧)的r=-0.407、-0.392、-0.388;STHW_(右侧)的r=-0.422、-0.410、-0.392;ADC值的r=-0.465、-0.445、-0.431,P<0.05)。结论AD患者海马区结构呈明显萎缩现象,且与患者认知功能呈显著相关性。通过MRI检查可了解海马区不同结构的萎缩程度,为临床诊断提供参考。Objective To investigate the value of MRI on hippocampal structure in patients with Alzheimer’s disease(AD)and the relationship between related parameters and cognitive function.Methods Totally 118 patients with AD in the Chengdu 363 Hospital Affiliated to Southwest Medical University were selected as study group,and 80 healthy subjects with physical examination were included in control group.MRI was used to scan the hippocampus of all subjects.The differences in hippocampal structure parameters and MRI parameters were compared between groups.The cognitive status of patients in study group was evaluated by Montreal cognitive assessment scale(MoCA).According to the MoCA score,the patients were divided into normal cognition group(n=75)and cognitive disorder group(n=43),and the hippocampal structure parameters and MRI parameters were compared,and the relationship with cognitive function was analyzed.Results The HFA,SHFA,HTD and SHTD in study group were significantly lower than those in control group(P<0.05),while the THW and STHW were significantly higher than those in control group(P<0.05),but there were no statistical differences in HSD,SHSD,LFW and SLFW between the two groups(P>0.05).The FA value in study group was significantly lower than that in control group(P<0.05),while the ADC value was significantly higher(P<0.05).The HFA,SHFA,HTD and SHTD in cognitive disorder group were significantly lower(P<0.05),while the THW and STHW were significantly higher compared to normal cognition group(P<0.05),but the HSD,SHSD,LFW and SLFW were not statistically different between the two groups(P>0.05).The FA value in cognitive disorder group was significantly lower(P<0.05),while the ADC value was significantly higher than that in normal cognition group(P<0.05).Pearson correlation coefficient analysis showed that hippocampal MRI parameters SHFA,SHTD and FA were significantly positively correlated with MoCA score,MMSE score and ADL score in AD patients(SHFA _(left):r=0.381,0.373,0.370;SHFA _(Right):r=0.449,0.432,0.422;SHTD _(

关 键 词：老年性痴呆 磁共振成像 海马结构 认知功能 相关性 

分 类 号：R749.16[医药卫生—神经病学与精神病学]