血管性痴呆与阿尔茨海默病的临床特征比较

目的探讨血管性痴呆(vascular dementia,VD)、阿尔茨海默病(Alzheimer’s disease,AD)与认知功能障碍的关系。方法采用MRI技术测定VD30例、AD20例患者脑叶和海马体积。应用MMSE评定受试者认知功能。结果不同痴呆阶段的VD和AD患者有着不同的临床特征,两者之间的鉴别指标随痴呆的进展而变化。颅脑MRI对AD患者海马测定显示萎缩明显,VD患者虽然也有不同程度的海马萎缩,但萎缩程度明显低于AD(P<0.01);与此对应,AD患者的颞角也较VD患者明显加深(P<0.05),为海马萎缩的间接证据。VD患者MMSE评分的降低与额叶、颞叶萎缩程度呈正相关。颅脑MRI对VD患者的测定显示多发病灶较单发病灶、双侧病灶较单发病灶、病灶总体积>50 mm3较<50 mm3的患者,认知功能评分的降低亦更显著。结论VD和AD具有不同的临床特征,两者间的差别是由各自的病变性质、部位和病理生理机制所决定的。

Studies on Relation Between Vascular Dementia, Alzheimer''''s Disease and Congnitive Dysfunction

Objective Studieson relation Between vascular dementia,Alzheimer's disease and congitive dysfunction.Methods Adopting MRI technology to determine 30 cases of VD and 20 cases of AD cerebral lobes and hippocampal volume,appling MMSE to evaluate the congnitive dysfunction of subjects.Results VD and AD patients have different clinical features in various demented stages,hence the indexes that differentiate the two dementia subtypes were changed accordingly.It is shown from craniocerebral MRI for AD patients,their hippocampal atrophy is obviously,although VD patients have also hippocampal atrophy to a certain extent,their atrophy is lower than AD(P<0.01),compared with this,AD patients' temporal angle i deeper obviously than VD patients(P<0.05),it is the indirect evidence of hippocampal atrophy.The decrease of the volumes of the frontal and temporal lobes were positively correlated with the decrease of MMES scores.It is shown from craniocerebral MRI for VD patients determination,patients with frequently ecountered focus and single focus,both sides focus and single focus,total area of focus larger than 50mm~3 and smaller than 50mm~3,their congnitive function determination is reduced remarkably.Conclusion VD and AD have a different features,the difference between VD and AD is decided by its pathologic change property,location and pathological physiological mechanism.