阿尔茨海默病患者扣带回后部波谱磁共振对照研究

目的 研究阿尔茨海默病(AD)患者脑扣带回后部氢质子波谱磁共振(H-MRS)特征以及与简易智能状态检查量表及老年性痴呆评定量表认知分量表评分的相关性.方法 对象为24例阿尔茨海默病患者(AD组),以及年龄、性别及受教育年限与之相匹配的8例血管性痴呆患者(VD组)、11名正常对照老人(NC组).对入组者应用H-MRS测量脑扣带回后部NAA/Cr值和ml/Cr值,并进行MMSE及ADAS-Cog评分.结果 AD组扣带回后部NAA/Cr值为1.24±0.12,ml/Cr值为0.74±0.15,VD组扣带回后部NAA/Cr值为1.25±0.15,ml/Cr值为0.65±0.15,NC组扣带回后部NAA/Cr为1.46±0.19,ml/Cr值为0.62±0.09,三组比较只有NAA/Cr值差异有统计学意义.组间比较提示AD组和VD组扣带回后部NAA/Cr值与NC组比较差异均有统计学意义.AD组扣带回后部mI/Cr值与NC组比较差异有统计学意义.而VD组扣带叫后部mI/Cr值与NC组比较差异无统计学意义.AD组与VD组扣带回后部NAA/Cr值和mI/Cr值比较差异均无统计学意义.以NAA/Cr值<1.31为标准,AD诊断的阳性预测值为73%,阴性预测值为71%.AD组脑扣带回后部NAA/Cr值(r=0.731,P=0.000)与MMSE评分旱显著正相关;与ADAS-cog评分旱显著负相关(r=-0.541,P=0.011).结论 AD患者脑扣带回后部NAA/Cr值明显降低,与MMSE和ADAS-cog评分有相关性,脑扣带回后部H-MRS检查不能很好区分早期AD与VD.

Hydrogen proton MR spectroscopy of posterior portion cingulate gyrus of patients with Alzheimer's disease: a ease control study

Objective To investigate the characteristics of hydrogen proton magnetic resonance spectroscopy (H-MRS) in posterior portion cingulate gyrus and the correlations thereof with the results of mini-mental state examination (MMSE), Alzheimer disease assessment scale-cognitive (ADAS-cog) in patients with mild-moderate Alzheimer's disease (AD). Methods H-MRS in posterior portion cingulate gyms was conducted in gender, age, and educational background-matched 24 patients with AD, 8 patients with vascular dementia (VD) ,and 11 normal controls (NC group) to measure the values of NAA(N-acetyl aspartate)myo-inositol (mI),and creatine and phosphocreatine (Cr). All the4 subjects underwent MMSE and assessment with ADAS-cog as well. The correlations among these results were assessed. Results The NAA/Cr ratios in posterior portion cingnlate gyrus of the AD and VD groups were (1.24±0.12) and (1.25 ±0.15) respectively, both significantly lower than that of the NC group (1.46±0.19), P = 0.003, P =0.017] without significant difference between the AD and VD groups (P =0.800). The ml/Cr value of the AD group was (0.74±0.15), not significantly different from that of the VD group (0.65±0.15), P = 0.153], and significantly higher than that of the NC group (0.62±0.09), P= 0.007], however, the mI/Cr value of the VD group was not significantly different from that of the NC group (P = 0.662). If the NAA/Cr ratio < 1.31 was used as criteria of AD,the positive predictive value of AD was 73% and negative predictive value was 71% . The NAA/Cr ratio was positively correlated with the MMSE score (r =0.731 ,P = 0.000), and negatively correlated with the ADAS-cog score (r = - 0.541, P = 0.011). Conclusions The NAA/Cr ratio decreases in the posterior portion cingulate gyrus of AD patients, and has statistical significant correlations with the score of MMSE and ADAS-cog. The H-MRS characteristics of posterior portion cingnlate gyrus cannot effectively differentiate the early AD from early VD.