扩瞳试验作为Alzheimer病辅助诊断的初步研究

Pupil dilatation test as a supplementary diagnostic tool for Alzheimer's disease

目的 探索扩瞳试验能否作为Alzheimer病的辅助诊断标志。方法 11例Alzheimer病(老年性痴呆,AD)患者及16名正常老年人,以0.01％Tropicamide溶液滴眼,用红外线摄象方法连续记录瞳孔变化共40分钟,与滴眼前瞳孔大小相比,计算扩大的程度。用t检验及非参数检验方法对两组进行统计比较。结果 在第19和20分钟时,正常对照组的瞳孔分别扩大2.4％和5.7％,而AD组分别扩大17.9％和19.1％,二者具有显著差异(P<0.05)。若以滴药后第19分钟时瞳孔扩大10％作为鉴别是否AD的分界值,敏感性为0.75,特异性为0.75。结论 扩瞳试验有可能作为Alzheimer病的辅助诊断标志,但尚需扩大样本,改进方法,进一步予以研究后才能定论。

To evaluate the accuracy of pupil dilatation test as a diagnostic tool for Alzheimer's disease. Methods The changes in pupil size of 11 patients with Alzheimer's disease (AD) and 16 normal controls after instillation of 0. 01% tropicamide were determined by continuous vediocamera method. The percentages of dilatation in two groups were compared with test and Kruskal-Wallis statistical method. Results At 19th and 20th minute after instillation, the pupil of normal control was dilated 2. 4% and 5. 7% separately, while that of AD were 17. 9% and 19. 1%, with significant difference, p<0. 05. Using 10% dilatation as the cut-off point for differential diagnosis, the sensibility of the test was 0. 75, while the specificity was 0. 75. Conclusions Pupil dilatation test could be used as a supplementary diagnostic tool for Alzheimer's disease but it has to be settled down after the confirmation by further research in much more cases.