PET脑显像和脑脊液检测对临床痴呆诊断再评估的意义
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基金项目:辽宁省自然科学基金资助项目(20140220066,20170540927)


Meaning of re-evaluation for clinical dementia diagnosis by brain PET imaging and CSF test
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    摘要:

    目的对首次临床诊断的痴呆患者进行再评估,寻找更适合的诊断方法与标准。方法择2011年6月 ~2012年6月共22例轻度神经退行性非血管性痴呆患者进行脑匹兹堡复合物B(PIB)-PET、选脱氧葡萄糖(FDG)-PET、脑脊液检测和神经心理学测试,每隔 1~2年进行一次简易智力状态量表(MMSE)评分,随访至 2017年4月。结果 22例受试者中 7例的痴呆诊断发生了改变。其中有 4例阿尔茨海默病转变为路易体痴呆; 2例阿尔茨海默病和 1例行为变异型额颞叶痴呆转变为不定型痴呆。诊断有变化组和无变化组的教育程度、 Aβ42浓度、理解能力测试、情景记忆测试及顶叶脑葡萄糖代谢减低程度差异有统计学意义(P< 0.05)。结论 PET脑显像和脑脊液检测对临床痴呆诊断再评估具有指导意义。

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    Objective To find better diagnostic methods and criteria by re-evaluation for initial clinical dementia diagnosis. Methods Totals of 22 subjects diagnosed as mild neurodegenerative non-vasculardementia from June 2011 to June 2012 were included. Brain PIB and FDG PET,CSF test and neuropsychological tests were assessed in all patients. MMSE test was measured every 1-2 years untill April 2017. Results The diagnosis of 7 out of 22 subjects was changed. 4 patients diagnosed with Alzheimer disease (AD)changed to dementia with Lewy bodies (DLB),while 2 AD patients and 1 behavioural variant frontotemporal dementia (bvFTD)patientchanged to unspecified dementia (UNS). There were significant differences between changed and non-changed team in educational level,Aβ42 concentration,comprehension test,episodic memory test and reductions in regional cerebral glucose metabolism(P<0.05). Conclusions Brain PET imaging and CSF test have guiding significance for re-evaluation for clinical dementia diagnosis.

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王治国 张宗鹏 吴锐先 战莹 武晓丹 张国旭. PET脑显像和脑脊液检测对临床痴呆诊断再评估的意义[J].神经疾病与精神卫生,2017,17(7):
DOI :10.3969/j. issn.1009-6574.2017.07.006.

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  • 在线发布日期: 2017-09-21