阿尔茨海默病患者海马结构的断层影像学研究

Sectional imaging study of the hippocampus in patients with alzheimer’s disease

目的观察阿尔茨海默病(AD)发病进程中海马结构在断层影像上的形态学改变。方法依据AD发病进程,分别采集正常对照(NC)组、轻度认知损害(MCI)组、AD组各34例共102例受试者脑核磁共振图像,每组男、女各17例。观测海马面积、横径、矢径和颞叶钩回间距、颞角宽度等。分析组间各测量值变化趋势,以及海马面积等相关测量值与各神经评定量表评分的相关性。结果各组海马面积侧别均无统计学差异。各组间测量值比较,AD组海马面积小于NC组及MCI组(P均<0.05);AD组海马横径小于NC组及MCI组,MCI组海马横径小于NC组(P均<0.01);AD组颞叶钩回间距大于NC组及MCI组(P均<0.01),MCI组颞叶钩回间距大于NC组(P<0.05)。海马面积、海马横径与临床痴呆分级量表(CDR)及汉密尔顿抑郁量表(HAMD)评分均呈负相关,与蒙特利尔认知评估量表(MoCA)评分均呈正相关;颞叶钩回间距与神经心理量表评分相关性同海马面积、海马横径相反。结论海马面积与海马横径随AD病情进展逐渐缩小,颞叶钩回间距随AD病情进展逐渐增大;海马结构的改变可损伤其认知功能。

Objective To observe the morphological changes on sectional imaging of the hippocampal formation(HPF)in patients in the process of alzheimer’s disease(AD).Methods According to the pathogenesis of AD,34 cases of a normal control(NC)group,34 cases of a mild cognitive impairment(MCI)group,34 cases of an AD group,which a total of 102 cases were collected,with 17 cases of male and17 cases of female in each group respectively.The hippocampal area,the transverse diameter,the sagittal diameter and the temporal lobe hook gyrus spacing,the temporal horn width were measured.The change trend of the measured values among the groups and the correlation between the hippocampal area and the scores of the neural rating scale were analyzed.Results There was no statistical difference of hippocampal area in the three groups.Compared with the measured values among the groups,the hippocampal area of the AD group was smaller than that of the NC group and the MCI group(P<0.05).The hippocampal transverse diameter of the AD group was smaller than that of the NC group and the MCI group,and the hippocampal transverse diameter of the MCI group was smaller than that of the NC group(all P<0.01).In AD group,the temporal lobe hook gyrus spacing was greater than that in the NC group and the MCI group(all P<0.01),and in MCI group,the temporal lobe hook gyrus spacing was greater than that in the NC group(P<0.05).Hippocampal area and hippocampal transverse diameter were negatively correlated with clinical dementia scale(CDR)and Hamilton depression scale(HAMD)scores,and positively correlated with Montreal cognitive assessment scale(MoCA)scores;the correlation between the distance of temporal lobe hook gyrus and the score of neuropsychological scale scores was opposite to that of hippocampal area and hippocampal transverse diameter.Conclusions With the progression of AD,the hippocampal area and hippocampal transverse diameter gradually decrease,while the temporal lobe hook gyrus spacing gradually increase.Changes in the hippocampus can damage its cognitive function.