阿尔茨海默病与颈动脉粥样硬化的相关性研究

目的 分析阿尔茨海默病(AD)和血管性痴呆(VD)与颈动脉粥样硬化的相关性,探讨血管因素在AD发病和病情变化中的作用. 方法 采用病例对照的研究方法 ,收集自2005年7月至2007年7月广州市脑科医院门诊和住院部收治的64例AD,42例VD患者,采用彩色多普勒检测颈总动脉(CCA)距分叉2 cm处,颈内动脉(ICA)距起始段膨大部位远端1.0～1.5cm处,观察动脉形态、颈动脉内膜-中层厚度(IMT)、动脉硬化斑块的形态大小和血管内径等.同期来院健康体检者为对照组(69例).痴呆患者行简易智能评分(MMSE). 结果痴呆患者IMT明显增加,内径明显扩大,斑块的发生率明显增高,与对照组比较,差异有统计学意义(P<0.05).但AD和VD两组患者相比较,IMT与斑块发生率差异无统计学意义(P>0.05).颈动脉粥样硬化程度及斑块与痴呆评分呈负相关(r=-0.389,P=0.000). 结论 颈动脉粥样硬化的形成与AD和VD发病密切相关,硬化程度与痴呆程度明显相关.

Correlation between Alzheimer's disease and carotid artery atherosclerosis

Objective To explore the correlation between Alzheimer's disease (AD), vascular dementia (VD) and carotid artery atherosclerosis. Methods This case-control study was conducted among 64 AD and 42 VD in-patients and out-patient admitted in Guangzhou Brain Hospital between July 2005 and July 2007, involving also 69 age- and gender-matched control subjects. Color Doppler ultrasound was performed to examine the artery shape, intima-media thickness (IMT), shape and size of the arteriosclerotic plaques, and diameter of the common carotid artery at 2 cm from the bifurcation and of the distal internal carotid artery 1.0-1.5 cm from the enlargement of the initial segment. Results Compared with those in the control group, the IMT, vascular diameter and arteriosclerotic plaques in the carotid artery were significantly increased in the dementia patients (P<0.05), but no obvious differences were found between the AD and VD patients. The degree of carotid artery atherosclerosis, represented by the number of plaques, was inversely correlated to the Mini-Mental State Examination scores (r=-0.389, P=0.000). Conclusion Carotid artery atherosclerosis is closely associated with the development of AD and VD, and the degree of atherosclerosis is positively correlated to the severity of dementia.