阿尔茨海默病与血管性痴呆病人临床特点及脑CT的对照研究  

Comparative study of clinical features and changes of brain CT of patients with Alzheimer′s disease and vascular dementia

作　　者：刘宜东[1] 曾昭祥[1] 张龚[1] 

机构地区：[1]山东省济宁市精神病防治院,272051

出　　处：《中国全科医学》2003年第10期815-817,共3页Chinese General Practice

摘　　要：目的　比较阿尔茨海默病 (AD)与血管性痴呆 (VD)病人的临床特点及脑CT表现。方法　根据ICD- 10诊断标准 ,对 2 3例AD和 2 7例VD病人的临床及颅脑CT进行了对比分析。结果　 (1)AD病人多起病缓慢 ,而VD病人起病多较急 ;AD病人的认知功能减退常常累及多个方面 ,而VD病人以记忆力和计算力减退为主 ;AD病人的非认知功能常常受影响 ,而VD病人的非认知功能受累较少。 (2 )AD病人的两脉络球间距离与侧脑室体部间最大外径之商和头颅内横径与侧脑室体部间最大外径之商均明显较VD为小 (P <0 0 1) ;第三脑室和外侧裂最大宽度则明显较VD为大 (P <0 0 1)。结论　根据两种疾病的不同临床特点及脑CT表现检查有助于AD及VD的诊断及鉴别诊断。Objective To compare the clinical features and changes of brain CT between patients with Alzheimer′s disease (AD) and vascular dementia (VD).Methods Twenty-three patients with AD and twenty-seven patients with VD were diagnosed according to the ICD-10 classification.The clinical features and changes of brain CT were compared between the two groups.Results (1)The course of AD was gradual decline.The course of VD was acute progression.The decline of intelligence in Alzheimer′s disease was not only in cognitive functions which was global decline,but also in non-cognitive functions sush as affective symptoms,behavior disorder,personality alteration and disturbance of perception.Contrarily,only parts of cognitive function in VD declined.(2)In the cases of AD,both the ratio of the distance between the two choroid plexus to the maximum distance between the outer surfaces of skull to the maximum distance between the outer surfaces of the body of lateral ventricles were less than those in VD (P<0.01).Also,both the third ventricle of brain and the maximum breadth of the lateral fissure in AD were larger than those in VD (P<0.01).Conclusion The different clinical manifestation and brain CT help to differentiate the diagnosis of AD and VD in clinical practice.

关 键 词：阿尔茨海默病 血管性痴呆 临床特点 CT 诊断 鉴别诊断 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R749.13[医药卫生—临床医学]