老年期痴呆患者的脑循环变化

The change of cerebral circulation in the patients with senile dementia

目的探讨老年期痴呆患者的脑循环变化。方法采用单光子发射计算机断层显像（ＳＰＥＣＴ），９９ｍＴｃ－ＥＣＤ作为显像剂，定量测定１５例Ａｌｚｈｅｉｍｅｒ型痴呆（ＤＡＴ）、２４例血管性痴呆（ＶＤ）和１５名正常老年人的局部脑血流量（ｒＣＢＦ）。结果ＤＡＴ、ＶＤ组大脑平均血流量（ｍＣＢＦ）均显著低于对照组（Ｐ＜０．０１）；ＤＡＴ组额、颞、顶叶皮质ｒＣＢＦ明显减少（Ｐ＜０．０１）；ＶＤ组各脑叶皮质及基底节区ｒＣＢＦ显著降低（Ｐ＜０．０１）；ＤＡＴ颞、顶叶皮质，ＶＤ额叶皮质ｒＣＢＦ改变与神经心理测试ＭＭＳＥ呈正相关（均为Ｐ＜０．０５）。结论ＳＰＥＣＴ核素显像可以反映ＤＡＴ、ＶＤ的特征性脑血流分布，其对于老年期痴呆的预测和早期发现，以及ＤＡＴ。

Objective To explore the change of cerebral circulation in the patients with senile dementia. Methods Using SPECT 99m Tc ECD, rCBF was quantitatively determined in the following 3 groups: DAT group (n=15),VD group(n=24) and control group of normal elderly subjects(n=15). Results The mean CBF values of the brain were a significant reduction either in DAT or in VD compared with that in control subject group( P <0.01); The rCBF at temporal,parietal and frontal cortices in DAT group was remarkbly low ( P <0.01); The rCBF from all of cortical regions and basal ganglio was markedly decrease in VD group ( P <0.01). There was a positive correlation among the rCBF of temporal cortex,parietal cortex in DAT group, frontal cortex in VD group and MMSE( P <0.05). Conclusion SPECT imaging might reflect the characteristic distribution of rCBF in DAT and VD.The analysis of rCBF determined by SPECT quantitatively might have an important significance for prediction and early detection of senile dementia, and contributed to the differentiation between DAT and VD.