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目的 用神经心理学和脑血流灌注检查探讨轻度认知功能障碍 (MCI)特点 ,分析其与阿尔茨海默病 (AD)和健康衰老的差异。方法 对 2 1例MCI ,18例AD和 19例健康老人进行简易智力状态检查 (MMSE) ,日常生活能力量表(ADL)和总体衰退量表 (GDS)评定 ,韦克斯勒记忆测验 (WMS)及SPECT检查。SPECT结果作半定量分析 (以放射性计数比值 -RAR表示 )。结果 认知功能评定结果 :与健康老人相比 ,MCI除ADL成绩外 ,其余均显著降低 ;与AD相比 ,MMSE、ADL、GDS以及WMS中的短时记忆和语言记忆成绩均显著优于AD(P <0 0 5 )。脑血流灌注比较结果 :MCI组与健康老人各部位的RAR无差异 ;与AD组相比 ,扣带回、左基底节、左枕叶、右颞上回、双侧额叶、双侧颞下回和双侧顶叶RAR均显著增高 (P <0 0 5 )。以顶叶RAR为变量作聚类分析产生两类MCI(MCI 4和MCI 16) ,MCI 16在左丘脑的血流灌注低于健康老人(P <0 0 1) ,在双侧颞下回和右颞上回高于AD(P <0 0 1)。结论 MCI为一组异质性疾病 ,认知功能缺损和脑血流灌注的改变均存在多种类型。顶叶能对MCI进行有效分类。
Objective To investigate the characteristics of mild cognitive impairment (MCI) with neuropsychology and cerebral perfusion, and to analyze the differences between them and Alzheimer’s disease (AD) and healthy aging. Methods MMSE, ADL and GDS were evaluated in 21 MCI, 18 AD and 19 healthy controls. Wechsler Memory Test (WMS) ) And SPECT examination. SPECT results for semi-quantitative analysis (radioactive count ratio -RAR). Results Compared with healthy controls, MCI showed a significant reduction in ADL scores compared with healthy controls. Compared with AD, MMSE, ADL, GDS and WMS significantly improved short-term memory and verbal memory performance compared with AD (P <0 05). Cerebral blood flow perfusion comparison results: there was no difference in RAR between MCI group and healthy control group. Compared with AD group, there were no significant differences in RAR between cilia, left basal ganglia, left occipital lobe, right superior temporal gyrus, bilateral frontal lobe, The RAR of the next parietal and bilateral parietal lobes were significantly higher (P <0 05). Cluster analysis using the parietal RAR as a cluster generated two types of MCI (MCI 4 and MCI 16). The MCI 16 perfusion in the left thalamus was lower than that in the healthy controls (P <0.01) Right superior temporal gyrus was higher than AD (P <0.01). Conclusion MCI is a group of heterogeneous diseases, there are many types of changes in cognitive impairment and cerebral perfusion. The parietal lobe can effectively classify MCI.