阿尔茨海默病脑血流灌注特点与认知功能的相关性研究

Study on the Correlation between Cerebral Blood Perfusion Characteristics and Cognitive Function in Alzheimer's Disease

目的通过应用三维动脉自旋标记(arterial spin labeling 3DASL)技术探讨阿尔茨海默病(alzheimer disease,AD)皮质脑血流灌注与认知功能的相关性。方法收集石河子大学第一附属医院门诊及住院有明确诊断的AD患者20例(AD组),选择性别、年龄和受教育程度相匹配的认知功能正常者作为对照组,共20例(NC组)。通过磁共振3D-ASL技术对皮质脑血流量定量测量及神经心理学量表对受试者认知综合评价,分析二者的相关性。结果 (1)比较两组间性别、年龄、受教育程度,差异无统计学意义(P>0.05),两组间蒙特利尔认知评估量表(montreal cognitive assessment,Mo CA)评分差异有统计学意义(P<0.05);(2)AD组较NC组在右侧颞叶、双侧额叶、顶叶、枕叶、后扣带回、基底节区及小脑的脑血流量(cerebral blood flow,CBF)有不同程度降低,且差异具有统计学意义(P<0.05),在左侧颞叶的差异无统计学意义(P>0.05);(3)所有感兴趣脑区CBF值与Mo CA评分均成正相关(r=0.06-0.939,P<0.05)。结论 (1)认知功能检查Mo CA总分值与磁共振3D-ASL所测得的皮质脑血流之间存在良好的相关性,二者结合能更好的评价AD患者的脑功能改变。

Objective To investigate the relationship between cerebral cortical cerebral perfusion and the impairment of cognitive function by using three-dimensional arterial spin labeling(3D-ASL)technique.Methods Twenty patients(AD)who were diagnosed by neurologist in the First Affiliated Hospital of Shihezi University were enrolled in this study.Twenty patients(AD group)with normal sex,age and educational level were selected as the control group.Example(NC group).The cognitive function of the subjects was evaluated by magnetic resonance 3D-ASL technique.The cognitive function,the characteristics of cerebral blood perfusion,and the characteristics of the two groups were analyzed.Results(1)There were no significant differences in the sex,age and educational level between the two groups(P>0.05).The monteural cognitive assessment(MoCA)(P<0.05).(2)Compared with NC group,there were different signal intensity in bilateral frontal lobe,parietal lobe,occipital lobe,posterior cingulate gyrus,basal ganglia,cerebellum and right temporal lobe(P<0.05),but there was no significant difference in the left temporal lobe(P>0.05).(3)All the subjects had no significant difference in bilateral frontal lobe,temporal lobe and parietal lobe,The occipital lobe,the posterior cingulate gyrus,and the basal ganglia segment cerebral blood flow signal intensity were positively correlated with the total score of Mo CA.Conclusion(1)There was a good correlation between the gross score of cognitive function and the cortical cerebral blood flow measured by magnetic resonance 3D-ASL.The combination of MoCA had better correlation with each other and better evaluated AD patients with brain function changes.