扩瞳试验对阿尔茨海默病的预测效应

目的利用扩瞳试验对轻度认知功能损害(Mild cognitive impairment,MCI)患者进行研究,了解MCI、阿尔茨海默病(AD)与正常老年人在扩瞳试验结果之间的差异,分析MCI与AD之间的关系,并探讨扩瞳试验是否能作为MCI发展成AD的预测指标。方法收集AD患者30例、MCI患者28例以及健康对照34例。分别进行神经心理学测验和扩瞳试验。比较三组的神经心理学测验和扩瞳试验结果之间的差异。计算扩瞳试验在诊断AD和MCI时的敏感性和特异性。结果MCI组的神经心理学测验都显著好于AD组(P<0.001),但都明显不如正常对照组(P<0.001)。AD患者和MCI患者在滴入扩瞳剂后,瞳孔直径明显扩大,与NC组有显著差异(P值分别为P<0.05,P<0.001),而AD组与MCI组之间则无统计学上的差异(P>0.05)。扩瞳试验诊断AD的敏感性和特异性分别为60.0%和67.65%,诊断MCI的敏感性和特异性分别为71.43%和67.65%。结论扩瞳试验可以将MCI患者和AD患者、与正常老年人区别开来,可以作为MCI和AD的一个筛选诊断标志。MCI是AD与正常衰老之间的过渡状态;MCI患者是AD的高危人群...

Pupil dilation test: a predictive test for Alzheimer's disease

Objective: To compare patients with Alzheimer's disease,amnestic Mild Cognitive Impairment(a-MCI),and a group of healthy elderly persons on pupil dilation test.To determine whether pupil response to dilute tropicamide could be used as a diagnostic test for AD and MCI,and to investigate whether pupil dilation test could be used as a predictor for patients with a-MCI who will progress to AD.Methods: 30 patients with AD,28 patients with a-MCI and 34 healthy elderly persons were recruited.All of the participants finished a battery of neuropsychological tests and pupil dilation test.The results of neuropsychological tests of these three groups were compared.The sensitivity and the specificity of pupil dilation test were calculated.The differences of pupil dilation degree among AD,MCI and normal controls were analysed.Results:The scores of MMSE,WMS and GDS of MCI group were significantly higher than that of AD group(P<0.001),but were significantly lower than that of normal controls(P<0.001).ADL score of MCI group was significantly lower than that of AD group(P<0.001),and was significantly higher than that of normal controls(P>0.001).Mean percent change in pupil diameter of the treated eye showed a trend with faster maximzing dilation in AD group and MCI group,which were significantly different from the normal controls after instillation(P<0.05 and P<0.001 respectively).There was no difference of pupil dilation degree between AD group and MCI group(P>0.05).The sensitivity and the specificity of pupil dilation test for AD was 60.0% and 67.75% respectively.The sensitivity and the specificity of pupil dilation test for MCI was 71.43% and 67.75% respectively.Conclusion:AD and MCI could be distinguished from the healthy elderly by pupil dilation test which could be used as a screening diagnosing tool.MCI represents a transitional state between healthy aging and AD.Patients with MCI are individuals with high risk to progress to AD.