TCD在多发梗塞性痴呆和阿尔采默氏病鉴别诊断中的评价

Evaluation of TCD in differential diagnosing multi-infarct and Alzheimer dementia

目的 :评价经颅多普勒 (TCD)在多发梗塞性痴呆 (MID)和阿尔采默氏病 (DAT)鉴别诊断中的价值。方法 :应用TCD测量MID患者 (n =4 0 )DAT患者 (n =4 0 )在屏息实验、拇指对掌实验中大脑中动脉的平均血流速度。结果 :①MID组屏息指数BHI较DAT组明显降低。②MID组和DAT组大脑中动脉平均血流速度的增加在进行实验的肢体的同侧及对侧具有选择性。结论 :①BHI可以作为MID和DAT鉴别诊断的有效辅助指标。②TCD可以作为MID和DAT鉴别诊断的工具。

Objective To make an appraisal of the value of transcranial Doppler in the differential diagnosis of multi-infarct(MID) and Alzheimer dementia(DAT). Methods Using transcranial Doppler, measurements of flow velocity in the middlecerebral arteries during apnea and thumb-to-finger opposition tests were recorded in MID(n=30) and DAT (n=30) patients.Results (1) Cerebral reactivity to apnea was significantly lower( P <0.01) in the multi-infarct group compared with the Alzheimer group.(2) The increase of mean flow velocity had selectivity in the middle cerebral artery ipsilateral or contralateral to the hand performing the test in the multi-infarct group and the Alzheimer group.Conclusion These data suggest that (1) Breath-holding index(BHI) could be an valid additional index in the differential diagnosis of MID and DAT patients,and (2)TCD could be an tool in the differential diagnosis of MID and DAT patients.