头颅CT平扫在鉴别老年阿尔茨海默病与血管性痴呆患者中的临床应用

目的探讨头颅CT平扫在老年阿尔茨海默病(AD)和血管性痴呆(VD)患者鉴别诊断中的应用价值。方法选取2019年1月至2020年1月合肥市滨湖医院老年科收治的101例痴呆患者,其中55例阿尔茨海默病者作为AD组,46例血管性痴呆患者作为VD组,比较分析两组患者头颅CT检查结果。结果AD组大脑半球最大横径、大脑半球最大横径与侧脑室最大宽度比值小于VD组,AD组外侧裂池最大宽度大于VD组,差异有统计学意义(P<0.05)。VD组腔隙性脑梗死和大面积脑梗死/出血灶的发生率明显高于AD组,AD组侧脑室颞角扩大发生率高于VD组,差异有统计学意义(P<0.05)。结论头颅CT平扫在鉴别老年患者阿尔茨海默病和血管性痴呆方面具有较高的临床应用价值。

The clinical application of head CT scan in distinguishing senile patients with Alzheimer's disease and vascular dementia

Objective To explore the value of head CT scan in the differential diagnosis of Alzheimer’s disease(AD)and vascular dementia(VD)in elderly patients.Methods Select 101 patients with dementia admitted to the Department of Geriatrics,Binhu Hospital of Hefei from January2019 to January 2020,55 patients with Alzheimer’s disease were set as AD group and 46 patients with vascular dementia were set as VD group.The results of head CT examination of the two groups were compared and analyzed.Results The ratio of the maximum transverse diameter of cerebral hemisphere and the maximum transverse diameter of cerebral hemisphere to the maximum width of lateral ventricle in the AD group were smaller than that in the VD group,and the maximum width of lateral fissure in the AD group was larger than that in the VD group,with statistically significant difference(P<0.05).The incidence of lacunar infarction and large area cerebral infarction/hemorrhagic foci in the VD group were significantly higher than that in the AD group,and the incidence of lateral ventricular temporal horn enlargement in the AD group was higher than that in the VD group,with statistically significant difference(P<0.05).Conclusion Plain CT scan of the head has high clinical value in distinguishing senile patients with alzheimer’s disease and vascular dementia.