血管性痴呆和Alzheimer病的经颅多普勒超声研究

Transcranial Doppler sonography in vascular dementia and Alzheimer's disease

目的 探讨经颅多普勒超声 ( TCD)对血管性痴呆 ( VD)和 Alzheimer病 ( AD)的诊断价值。 方法 对 2 1例 VD、3 7例 AD老年患者及对照组 3 0例进行 TCD检测 ,并将结果进行分析。 结果 VD组 TCD异常率为 94 .2 %,AD组为 89.3 %。两组的异常表现相似 ,除 VD组 3例患者外 ,均表现为全脑平均血流速度降低 ,且显著低于对照组 (均为 P<0 .0 1 ) ,VD组与 AD组差异无显著性( P>0 .0 5)。痴呆的严重程度与脑血流速度呈正相关 ( VD组 r=0 .72 ,P<0 .0 1 ;AD组 r=0 .69,P<0 .0 5)。 结论 常规 TCD指标无法鉴别 VD、AD,但对揭示痴呆患者的脑血流动力学改变及判定痴呆的严重程度有一定价值。

Objective To study the diagnostic value of transcranial Doppler (TCD) in vascular dementia(VD) and Alzheimer's disease (AD). Methods Twenty one patients with VD, 37 patients with AD and 30 normal controls were examined with TCD and the data was analysed. Results The changes of TCD were similar between VD and AD. Except 3 cases with VD, the mean blood flow velocity in all cerebral arteries was decreased in the two groups and significantly lower than the normal control group ( P <0 01). There was no significant difference of the blood flow velocity between the VD and AD patients ( P >0 05).The mean cerebral blood flow velocity was correlated siginificantly with the severity of VD and AD. Conclusions Routine TCD can not differentiate VD and AD, but it is a valuable method to study the hemodynamic changes in patients with dementia and to evaluate the severity of dementia .