摘要
目的:探讨阿尔茨海默病(AD)患者脑微出血病灶的特点及其对认知障碍的影响及预测价值。方法:选取AD伴脑微出血(AD-CMBs)组患者37例;轻度认知障碍伴脑微出血(MCI-CMBs组)者42例;认知功能正常伴脑微出血(NC-CMBs)者39例,全部受试者影像学检查提示至少存在一个脑微出血病灶。全部受试者均完成神经心理学评估以及头颅磁共振扫描。比较三组的临床特点及脑微出血病灶的数量及部位,分析微出血病灶部位与不同认知域之间的相关性,并分析不同部位的脑微出血病灶对AD患者认知障碍的预测价值。结果:AD-CMBs组患者的脑微出血病灶数量明显高于两个对照组(p=0.001)。AD-CMBs组的脑叶微出血病灶的比例明显高于两个对照组(p=0.005)。此外,AD-CMBs组的脑叶微出血病灶数量与整体认知功能、工作记忆相关(r=-0.42,p=0.008;r=-0.43,p=0.001);AD-CMBs组深部/幕下的微出血病灶数量与信息处理速度相关(r=-0.51,p=0.001);MCI-CMBs组的脑叶微出血病灶数量与整体认知功能相关(r=-0.51,p=0.001)。最后与深部/幕下的微出血病灶相比,脑叶的微出血病灶数量对AD具有较好的预测价值(AUC=0.769 vs AUC=0.606;p=0.0015)。结论:AD患者中脑微出血病灶明显增多,并以脑叶微出血病灶增多为主。脑叶微出血与总体认知能力相关,对AD具有较好的预测价值。
Objective:To investigate the characteristics of cerebral microbleeds in patients with Alzheimer's disease(AD)and its effect on cognitive impairment.Methods:37 patients with AD-CMBs,42 patients with mild cognitive impairment(MCI)and cerebral microbleeds(MCI-CMBs),39 patients with normal cognitive function(NC)and cerebral microbleeds(MCI-CMBs)were recruited in this study.All subjects were underwent neuropsychological assessment and brain magnetic resonance imaging scan.The clinical characteristics,the number and location of cerebral microbleeds were compared among three groups,and the correlation between the location of microbleeds and different cognitive domains was analyzed,and the predictive value of different locations of cerebral microbleeds on AD patients was also analyzed.Results:The number of cerebral microbleeds in AD group was significantly higher than that in other two groups(p=0.001).The proportion of lobular microbleeds in AD CMBS group was significantly higher than that in other two groups(p=0.005).In addition,in AD-CMBS group,the number of lobular microbleeds was correlated with the overall cognitive function and working memory(r=-0.42,P=0.008;r=-0.43,P=0.001);the number of deep/infratentorial microbleeds in AD-CMBS group was related with the speed of information processing(r=-0.51,P=0.001)and the number of cerebral lobular microbleeds in MCI-CMBS group was correlated with overall cognitive function(r=-0.51,P=0.001).Finally,compared with deep/infratentorial microbleeds,the number of lobular microbleeds has a better predictive value for AD.Conclusion:The number of cerebral microbleeds in AD patients is significantly increased,especially the number of lobular microbleeds,which is related to the overall cognitive ability.And the lobular microbleeds might be a good marker for the recognition of AD.
作者
邵鹏飞
许衡衡
秦若梦
马俊怡
生晓宁
黄丽丽
赵辉
SHAO Peng-fei;XU Heng-heng;QIN Ruo-meng;MA Jun-yi;SHENG Xiao-ning;HUANG Li-li;ZHAO Hui(Department of Neurology,Affiliated Drum Tower Hospital,Nanjing University,Medical School Nanjing 210000,China)
出处
《阿尔茨海默病及相关病杂志》
2020年第4期277-283,共7页
Chinese Journal of Alzheimer's Disease and Related Disorders
基金
国家自然基金面上项目2018-2021年(编号:81771157)。
关键词
阿尔茨海默病
脑叶微出血
深部/幕下微出血
认知障碍
Alzheimer's disease
lobular microbleeds
deep/infratentorial microbleeds
cognitve impairment
