【摘要】 目的 基于氟[¹⁸F]贝他苯(¹⁸F-FBB)淀粉样蛋白（Aβ）PET显像，分析不同认知损害严重程度阿尔茨海默病(AD患者不同脑区的Aβ异常沉积特征，以及与认知功能的相关性。资料与方法 回顾性纳入2022年8月—2023年10月在复旦大学附属华山医院就诊的18例临床诊断高度可能AD患者，且¹⁸F-FBB PET显像均证实存在脑内Aβ异常沉积。根据症状严重程度分为AD源性轻度认知损害（MCI）组8例和痴呆组10例，另纳入正常对照者12例。基于脑部结构相MRI和自动解剖标记模板对3组受试者额叶、外侧顶叶、外侧颞叶、前后扣带回及复合皮质脑区Aβ异常沉积标准化摄取值比值进行半定量分析，并比较组间差异，分析AD患者脑内Aβ沉积程度与简易智能测试量表、蒙特利尔认知评估评分的相关性。结果 AD源性MCI和痴呆组在额叶、外侧颞叶、外侧顶叶、前后扣带回及复合皮质Aβ异常沉积的标准化摄取值比值均显著高于对照组（t=7.442～9.151,P均<0.05）；但AD源性MCI与痴呆组上述脑区Aβ异常沉积的标准化摄取值比值差异无统计学意义（t=0.312～0.996,P均>0.05）。AD源性MCI和痴呆组脑内Aβ沉积程度与简易智能测试量表、蒙特利尔认知评估评分均无显著相关性（r=-0.049～0.050,P均>0.05）。结论 AD源性MCI和痴呆组患者脑内Aβ异常沉积均显著高于正常对照组。但Aβ沉积无法鉴别不同认知损害程度的AD患者，在反映Aβ沉积评估AD临床症状的严重程度方面具有一定局限性。更多还原

【Abstract】 Purpose To investigate the characteristics of ¹⁸F-Florbetaben(¹⁸F-FBB) β-amyloid（Aβ） PET imaging in different brain regions of Alzheimer’s disease（AD） patients with different degrees of cognitive impairment, and to explore the correlation between Aβ deposition and cognitive dysfunction. Materials and Methods A total of eighteen patients with a clinical diagnosis of probable AD from August 2022 to October 2023 were retrospectively included in Huashan Hospital. All patients had Aβ abnormal deposition in the brain as confirmed by ¹⁸FFBB PET imaging. According to the severity of symptoms, they were divided into the AD-induced mild cognitive impairment（MCI） group（8 cases） and the dementia group（10 cases）. In addition, 12 healthy controls were included. First, the standardized uptake value ratio of abnormal Aβ deposition in the frontal lobe, lateral parietal lobe, lateral temporal lobe, anterior and posterior cingulate gyrus, and compound cortex was semi-quantitatively calculated and compared among the three groups based on the subjects’ brain MRI and automated anatomical labeling template. The correlation between the degree of Aβ deposition in the brains of AD patients and cognitive scale scores（mini-mental state examination, Montreal cognitive assessment） was then further analyzed. Results The standardized uptake value ratio values of Aβabnormal deposition in the frontal lobe, lateral temporal lobe, lateral parietal lobe, anterior and posterior cingulate cortex and compound cortex in the AD-induced MCI and dementia groups were significantly higher than those in the healthy controls（t=7.442-9.151, all P<0.05）. However,there was no significant difference in the standardized uptake value ratio values of Aβ abnormal deposition in the above brain regions between the MCI and dementia groups（t=0.312-0.996, all P>0.05）. In addition, there was no significant correlation between the degree of Aβ deposition in the brain and the cognitive scale scores（mini-mental state examination, Montreal cognitive assessment） in the AD-induced MCI and dementia groups（r=-0.049-0.050, all P>0.05）. Conclusion Aβ deposition in the brains of AD-induced MCI and dementia is significantly higher than in the healthy controls. However, Aβ deposition cannot identify AD patients with different degrees of cognitive impairment,reflecting that Aβ deposition has certain limitations in assessing the severity of clinical symptoms of AD.更多还原