血管性认知障碍无痴呆患者SPECT脑血流显像特点

发布时间：2018-03-13 12:32

本文选题：血管疾病　切入点：蒙特利尔认知评估量表　出处：《安徽医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的应用单光子发射计算机断层核素显像(SPECT)探讨血管性认知障碍无痴呆(VCIND)的局部脑血流量(rCBF)及放射性比值(RAR)的关系并分析MoCA和MMSE分数与各脑区的相关性。方法VCIND患者45例,其中男性20例,女性25例,同期年龄和性别相匹配的15例健康体检合格者为对照组,其中男性6例,女性9例。对所有研究对象进行一般检查、神经功能评定和脑SPECT检查。结果VCIND组患者与对照组相比双侧额叶、左侧顶上小叶、左侧丘脑rCBF及RAR值明显降低(P＜0.05),在VCIND组内左侧额叶、左侧顶上小叶、左侧丘脑均较右侧额叶、右侧顶上小叶、右侧丘脑rCBF及RAR值也明显降低(P＜0.05)。VCIND组MoCA子项中视空间与执行功能、抽象、注意、延迟记忆及MMSE子项中执行功能、回忆明显低于对照组(P＜0.05)。MoCA子项视空间与执行功能与右额叶、双侧顶上小叶、双侧颞叶内侧RAR值呈正相关;抽象与左额叶、左丘脑RAR值呈正相关;延迟记忆与左顶上叶、双侧颞叶内侧、左丘脑RAR值呈正相关;;注意与左颞叶内侧、左丘脑RAR值呈正相关MoCA总分与双侧额叶、左丘脑RAR值呈正相关。MMSE子项执行功能与右额叶RAR值呈正相关;回忆与左颞叶内侧RAR值呈正相关;MMSE总分与右额叶RAR值呈正相关。结论①S PECT脑灌注显像对于早期发现VCIND患者具有极其重要的意义;②左侧半球损害早于右侧,可能是VCIND患者重要的特点之一;③M oCA和MMSE分数与各脑区之间有一定的相关性;④MoCA量表在早期发现VCIND和预测预后优于MMSE。
[Abstract]:Objective to investigate the relationship between regional cerebral blood flow (rCBF) and radioactivity ratio (RAR) in patients with vascular cognitive impairment without dementia (VCIND) by single photon emission computed tomography (SPECT), and to analyze the correlation between MoCA and MMSE scores in different brain regions. Methods 45 VCIND patients, including 20 males and 25 females, and 15 healthy subjects matched with age and sex in the same period were selected as control group, including 6 males and 9 females. Nerve function evaluation and brain SPECT examination. Results the values of rCBF and RAR in bilateral frontal lobe, left superior parietal lobule and left thalamus in VCIND group were significantly lower than those in control group (P < 0.05). In VCIND group, left frontal lobe, left superior parietal lobule, left thalamus were significantly lower than those in right frontal lobe and right superior parietal lobule. The values of rCBF and RAR in the right thalamus also significantly decreased the visual space and executive function, abstract, attention, delayed memory and executive function in the MoCA subitem of the MoCA subitem in P < 0.05. VCIND group, and the recall was significantly lower than that in the control group (P < 0.05), the visual space and executive function of the subitem and the right frontal lobe of the MoCA subitem were significantly lower than those in the control group (P < 0.05). In bilateral superior parietal lobules, the medial RAR value of bilateral temporal lobe was positively correlated, abstract was positively correlated with left frontal lobe and left thalamus RAR value, delayed memory was positively correlated with left superior parietal lobe, bilateral medial temporal lobe, left thalamus RAR value, and attention was paid to left medial temporal lobe. The total score of RAR in left thalamus was positively correlated with bilateral frontal lobe, the RAR value of left thalamus was positively correlated with RAR value of right frontal lobe, and the total score of MMSE was positively correlated with RAR value of right frontal lobe, and the total score of RAR in left temporal lobe was positively correlated with RAR value of right frontal lobe. Conclusion 1S PECT cerebral perfusion imaging is of great significance in the early detection of VCIND patients. The lesion of the left hemisphere is earlier than that of the right. It may be one of the important features of VCIND patients that 3M oCA and MMSE scores have some correlation with each brain area. 4MoCA scale can detect VCIND in early stage and predict prognosis better than that of MMSE.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.1

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