【摘要】 目的对轻、中度阿尔茨海默病和路易体痴呆患者进行临床表现和1H-MRS研究,以期对疾病的早期诊断、鉴别诊断和治疗有所帮助。方法对10例阿尔茨海默病患者、6例路易体痴呆患者和8例对照者进行神经科检查、简易精神状态检查量表(MMSE)评分、半定量临床认知功能波动性评分(SCFCRS)和统一帕金森等级量表(UPDRS)评分。同时进行双侧海马的1H-MRS检查,测量NAA/Cr、Cho/Cr值。结果路易体痴呆较阿尔茨海默病患者表现出更明显的波动性认知功能障碍、反复出现的视幻觉和帕金森综合症样运动障碍。痴呆组较对照组有明显的双侧海马NAA/Cr值降低。阿尔茨海默病组较对照组有明显的双侧海马NAA/Cr值降低,路易体痴呆组较对照组左侧海马NAA/Cr值降低差异均有统计学意义。阿尔茨海默病组较路易体痴呆组左侧海马的NAA/Cr值降低、双侧海马的Cho/Cr值降低,但差异无统计学意义。结论患者海马NAA/Cr值降低能为阿尔茨海默病和路易体痴呆的早期诊断提供有价值的信息,有效指导临床治疗。对两组痴呆间1H-MRS的差异开展进一步的研究将有助于临床早期的鉴别诊断。更多还原

【Abstract】 Objective To analyze the clinical manifestations and ()~1H-magnetic resonace spectroscopy(~1H-MRS)examinations of Alzheimer’s disease and dementia with Lewy Body,and further provide evidence for early diagnosis,differential diagnosis and treatment.Methods 10 cases of Alzheimer’s disease,6 cases of dementia with Lewy Body and 8 controls received neurological examinations,mini-mental state examine(MMSE),SCFCRS and unified Parkinson disease rating score(UPDRS).Meanwhile,NAa/Cr and Cho/Cr ratios of bilateral hippocampus were also measured through()~1H-MRs.Results Compared with patients of Alzheimer’s disease,those with dementia with Lewy Body exhibited more obvious fluctuant cognitive function impairment,repeating visual hallucinations and Parkinsonism movement impediment.Compared with the control group,NAA/Cr ratios of bilateral hippocampus in Alzheimer’s disease group significantly devreased(P<0.05),as well as those of left hippocampus in dementia group.Compared with dementia group,NAA/Cr ratios of NAA/Cr ratios of left hippocampus and Cho/Cr ratios of bilateral hippocampus in Alzheimer’s disease group statistically non-significantly decreased.Conclusions The decrease of hippocampus NAA/Cr ratios of patients with Alzheimer’s disease and dementia with Lewy body might be helpful for their early diagnosis and effective treatment.And further investigations on the difference of()~1H-MRS between two diseases might contribute to their early differential diagnosis.更多还原