脑血管性痴呆与帕金森病神经心理学测验和脑单光子发射计算机断层扫描的对照研究

The comparison of vascular dementia and Parkinson disease using neuropsychological tests and single photon emission computed tomography

目的 研究脑血管性痴呆（ Ｖ Ｄ） 与帕金森病（ Ｐ Ｄ） 在神经心理学测验及脑单光子发射计算机断层扫描（ Ｓ Ｐ Ｅ Ｃ Ｔ） 的诊断和鉴别诊断的意义。方法 对３０ 例 Ｖ Ｄ、３１ 例 Ｐ Ｄ 和３０ 名正常老年人（ Ｎ Ａ） 进行神经心理学测验和 Ｓ Ｐ Ｅ Ｃ Ｔ 检查并比较检测结果。结果 神经心理学各项总分 Ｖ Ｄ 组最低［ 除积木测验（ Ｂ Ｄ） 外］ ， Ｐ Ｄ 组次之， Ｎ Ａ 组最高；３ 组间差异均有非常显著性（ Ｆ＝ １８６７ ～６３９５ ， Ｐ＜００１） 。在 Ｓ Ｐ Ｅ Ｃ Ｔ的检查中， Ｖ Ｄ 除额叶、左丘脑和右枕叶外余各脑区血流灌注均低于 Ｎ Ａ 组（ Ｐ＜００５） ， Ｐ Ｄ 则为顶叶、颞叶、基底节和丘脑血流灌注低于 Ｎ Ａ 组（ Ｐ＜ ００５） 。结论 Ｖ Ｄ 和 Ｐ Ｄ 的神经心理学测验和脑 Ｓ Ｐ Ｅ Ｃ Ｔ各有其特点，这两项检查可作为诊断和鉴别诊断 Ｖ Ｄ 和 Ｐ Ｄ 的辅助手段。

Objective To explore the diagnostic characteristics of neuropsychological tests and brain SPECT in the patients with vascular dementia (VD) and Parkinson′s disease (PD) Methods Five neuropsychological tests and SPECT were performed in 30 normal aged (NA) subjects, 30 patients with VD and 31 patients with PD to compare the difference in cognitive functions and cerebral perfusion Results Cognitive functions assessed by neuropsychological tests showed NA>PD>VD The cognitive impairment mode of VD was similar to PD The cerebral perfusion of VD was significantly decreased compared to that of NA in frontal, left thalamus and right occipital cortex The perfusion was asymmetrical in VD, with a significant decrease in left parietal, left temporal and right thalamus Conclusions Neuropsychological tests and brain SPECT are helpful in the diagnosis and differentiation between VD and PD