阿尔茨海默痴呆的诊断与鉴别诊断

Diagnosis and differentiation of Alzheimer' dementia

阿尔茨海默痴呆的诊断像所有疾病的诊断一样,最重要、最可靠的依据是临床过程。详细的临床症状发生发展过程,正规的神经心理评价,恰当的结构影像以及功能影像的辅助,对于诊断和鉴别阿尔茨海默痴呆与其他变性病性痴呆有重要价值。对于阿尔茨海默痴呆临床过程和诊断的关注已经提前到了临床前期和前驱期,但是目前还只是研究的方向,脑脊液的生物标志物的探讨是有重要价值的目标。变性病痴呆有很多种,阿尔茨海默痴呆虽然患病率最高,占60%～75%,但是仍然要注意避免阿尔茨海默痴呆的过度诊断。

The most important and reliable basis for diagnosis of Alzheimer＇ dementia is the clinical cause which is same to all the other diseases. The detail developing cause of clinical symptom and signs, the formal neuropsychological assessment, and the construction imaging and the functional imaging, combined the all are important for Alzheimer＇ dementia diagnosis and differentiation, the traditional and useful diagnosis criteria are two-step approach： first, identifying dementia according to degree of functional disability and secondly, specifying its cause. The diagnosis of future are define the clinical, biochemical, structural, and metabolic presence of AD at predementia phase. Although Alzheimer＇ dementia is the most common one among degeneration dementia,there are still a lot of other kind of dementia, like FTD, LBD, ETC. We should pay attention about the over diagnosis of Alzheimer＇ dementia.