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目的应用经颅多普勒(TCD)检测阿尔茨海默病(AD)患者脑血流动力学变化,探讨该变化与AD患者认知功能受损之间的联系。方法选取AD患者40例(AD组)和认知功能正常且年龄与之匹配的老年患者43例(对照组),应用TCD检查两组所探测颅内动脉的平均血流速度(MFV)和搏动指数(PI),并对其结果进行对比;同时分析其与认知功能的关系,ROC曲线计算各血流动力学参数曲线下面积。结果 AD组所探测颅内动脉MFV值均较对照组减低,PI值均较对照组升高,差异均有统计学意义(均P<0.05)。AD组简易智能状态检查表评分与所探测颅内动脉平均MFV呈正相关(r=0.82,P<0.05),与平均PI呈负相关(r=-0.81,P<0.05)。所探测颅内动脉血流动力学参数的ROC曲线下面积均>0.7。结论颅内动脉MFV降低和PI升高是AD患者脑血流动力学的变化特点,该变化的程度与认知功能受损的程度相关。TCD不仅对AD具有一定的诊断价值,还可评估AD患者的认知功能,具有重要临床应用价值。
Objective To detect the changes of cerebral hemodynamics in patients with Alzheimer’s disease (AD) by transcranial Doppler (TCD) and to explore the relationship between the changes and cognitive impairment in AD patients. Methods Forty-three elderly patients with normal cognitive function and matched age were enrolled in the study. TCD was used to detect the mean blood flow velocity (MFV) and pulse rate of the intracranial arteries in both groups (AD group) Index (PI), and compare the results; at the same time analyze its relationship with cognitive function, ROC curve to calculate the area under the hemodynamic parameter curve. Results The MFV of intracranial arteries detected in AD group were lower than those in control group, and the PI values were higher than those in control group (all P <0.05). The scores of simple intelligent state checklist in AD group were positively correlated with the mean MFV of intracranial arteries detected (r = 0.82, P <0.05), and negatively correlated with mean PI (r = -0.81, P <0.05). The area under the ROC curve of intracranial hemodynamic parameters were all> 0.7. Conclusion The decrease of MFV and the increase of PI in intracranial arteries are characteristics of cerebral hemodynamics in AD patients. The degree of change is related to the degree of impaired cognitive function. TCD not only has certain diagnostic value for AD, but also can evaluate the cognitive function of AD patients and has important clinical value.