海马萎缩率测量在认知功能障碍中的应用价值研究

The Application of Annual Hippocampal Atrophic Rate in the Detection of Early Cognitive Decline

目的观察海马萎缩率在不同人群中的变化,探索其早期发现认知功能下降的应用价值。方法选择2012年河北医科大学第四医院健康体检人群、遗忘型轻度认知功能障碍(aMCI)患者、阿尔茨海默病(AD)患者各35例进行随访,随访频率为1次/年,随访时间5年,排除因各种原因未能按期完成随访的对象,根据认知功能进展情况最终分为以下4组,健康体检人群(NG)组23例、未进展为AD的aMCI(aMCI-S)组25例、进展为AD的aMCI(aMCI-AD)组10例、AD组15例。比较4组认知功能[以简易智力状态检查量表(MMSE)评分下降率表示]、海马体积(HV)、海马萎缩率,并分析海马萎缩率与认知功能的相关性。结果 AD组MMSE评分、HV低于NG组、aMCI-S组和aMCI-AD组(P<0.05);AD组MMSE评分下降率高于NG组、aMCI-S组和aMCI-AD组(P<0.05);aMCI-AD组MMSE评分下降率高于NG组和aMCI-S组(P<0.05)。AD组患者海马萎缩率高于NG组、aMCI-S组和aMCI-AD组(P<0.05);aMCI-AD组海马萎缩率高于NG组和aMCI-S组(P<0.05)。海马萎缩率与MMSE评分下降率呈正相关(r=0.745,P<0.001)。结论海马萎缩率可准确及时反映认知功能下降的高危aMCI人群,从而为患者提供更加及时的干预治疗。

Objective To investigate the changes in the annual hippocampal atrophy rate in different populations and to explore their value in detecting early cognitive decline.Methods Study subjects were selected from among healthy people who underwent a physical examination（n=35）,patients with amnestic mild cognitive impairment（aMCI）（n=35） and patients with Alzheimer＇s disease（AD）（n=35）,who were treated in the Fourth Affiliated Hospital of Hebei Medical University in 2012.The frequency of follow-up visitation was once per year,the time of follow-up was 5 years.Subjects who did not complete the follow-up for various reasons were excluded.According to the changes in cognitive function during the follow-up period,the subjects were divided into the following four groups：normal（NG,n=23）,stable aMCI（aMCI-S,n=25）,aMCI progressing to AD（aMCI-AD,n=10） and AD（n=15）.The cognitive function[evaluated according to the decrease in MiniMental State Exam（MMSE） score],hippocampal volume（HV） and annual hippocampal atrophy rate were compared among the four groups,and their correlation was analyzed.Results The MMSE score and HV in the AD group were lower than those in the NG,aMCI-S and aMCI-AD groups（P〈0.05）;the decrease in MMSE score in AD group was greater than those in the NG,aMCI-S and aMCI-AD groups（P〈0.05）;the decrease in MMSE score in the aMCI-AD group was greater than those in the NG and aMCI-S groups（P〈0.05）.The annual hippocampal atrophy rate in the AD group was higher than those in the NG,aMCI-S and aMCI-AD groups（P〈0.05）,and the annual hippocampal atrophy rate in the aMCI-AD group was higher than those in the NG and aMCI-S groups（P〈0.05）.The annual hippocampal atrophy rate was positively correlated with the decrease in MMSE score（r=0.745,P〈0.001）.Conclusion The annual hippocampal atrophy rate accurately reflects the decline in cognitive function in a high-risk aMCI population.Monitoring the annual hippocampal atrophy rate is helpful for early detection and intervention in high-risk patients.