中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2001年
1期
49-51
,共3页
赵晋华%赵佩琴%孟娟娟%陈慧东%赵燕%刘福源
趙晉華%趙珮琴%孟娟娟%陳慧東%趙燕%劉福源
조진화%조패금%맹연연%진혜동%조연%류복원
糖尿病,非胰岛素依赖型%脑%局部血流%认知%体层摄影术,发射型计算机,单光子
糖尿病,非胰島素依賴型%腦%跼部血流%認知%體層攝影術,髮射型計算機,單光子
당뇨병,비이도소의뢰형%뇌%국부혈류%인지%체층섭영술,발사형계산궤,단광자
目的 探讨无低血糖发作的2型糖尿病(DM)患者的局部脑血流灌注特征及其与认知功能障碍的关系。方法 符合WHO糖尿病诊断标准的中年2型DM患者11例,年龄46~59岁。对照组为11例无神经精神疾病史的健康人,年龄41~58岁。认知功能测定选用韦氏成人记忆量表(WMS)、连线测验A、威斯康星卡片分类试验(WCST)。常规99Tcm-双半胱乙酯(ECD) SPECT脑血流灌注显像,半定量分析在横断面图像7~11帧进行。结果 ①2型DM组各项认知测验成绩普遍低于对照组,差异有显著性。表现在记忆量表中反映长时记忆的累加项、反映短时记忆的视觉再认项、联想学习项和总记忆商均显著低于对照组;连线测验完成时间较对照组慢;WCST成绩明显低于对照组。②2型DM患者存在局部脑血流灌注的减低,尢其是额叶、颞叶和顶叶。③2型DM患者的脑血流灌注显像右额叶局部脑血流(rCBF)值分别与WMS中的累加项、理解项呈正比相关,与WCST中的坚持性错误(%)成负相关;右颞叶rCBF值与韦氏记忆量表中的背数项呈正相关。结论 ①血糖控制较好、无反复低血糖发作的2型DM患者仍然存在中枢神经系统损害,临床表现为记忆力、注意力减退,推理判断及概括能力下降等认知技能损害。②2型DM患者存在不同程度的额、颞、顶叶血流灌注减低,并且额颞叶的血流灌注与记忆力、判断力、概括力、思维的灵活性有相关关系。
目的 探討無低血糖髮作的2型糖尿病(DM)患者的跼部腦血流灌註特徵及其與認知功能障礙的關繫。方法 符閤WHO糖尿病診斷標準的中年2型DM患者11例,年齡46~59歲。對照組為11例無神經精神疾病史的健康人,年齡41~58歲。認知功能測定選用韋氏成人記憶量錶(WMS)、連線測驗A、威斯康星卡片分類試驗(WCST)。常規99Tcm-雙半胱乙酯(ECD) SPECT腦血流灌註顯像,半定量分析在橫斷麵圖像7~11幀進行。結果 ①2型DM組各項認知測驗成績普遍低于對照組,差異有顯著性。錶現在記憶量錶中反映長時記憶的纍加項、反映短時記憶的視覺再認項、聯想學習項和總記憶商均顯著低于對照組;連線測驗完成時間較對照組慢;WCST成績明顯低于對照組。②2型DM患者存在跼部腦血流灌註的減低,尢其是額葉、顳葉和頂葉。③2型DM患者的腦血流灌註顯像右額葉跼部腦血流(rCBF)值分彆與WMS中的纍加項、理解項呈正比相關,與WCST中的堅持性錯誤(%)成負相關;右顳葉rCBF值與韋氏記憶量錶中的揹數項呈正相關。結論 ①血糖控製較好、無反複低血糖髮作的2型DM患者仍然存在中樞神經繫統損害,臨床錶現為記憶力、註意力減退,推理判斷及概括能力下降等認知技能損害。②2型DM患者存在不同程度的額、顳、頂葉血流灌註減低,併且額顳葉的血流灌註與記憶力、判斷力、概括力、思維的靈活性有相關關繫。
목적 탐토무저혈당발작적2형당뇨병(DM)환자적국부뇌혈류관주특정급기여인지공능장애적관계。방법 부합WHO당뇨병진단표준적중년2형DM환자11례,년령46~59세。대조조위11례무신경정신질병사적건강인,년령41~58세。인지공능측정선용위씨성인기억량표(WMS)、련선측험A、위사강성잡편분류시험(WCST)。상규99Tcm-쌍반광을지(ECD) SPECT뇌혈류관주현상,반정량분석재횡단면도상7~11정진행。결과 ①2형DM조각항인지측험성적보편저우대조조,차이유현저성。표현재기억량표중반영장시기억적루가항、반영단시기억적시각재인항、련상학습항화총기억상균현저저우대조조;련선측험완성시간교대조조만;WCST성적명현저우대조조。②2형DM환자존재국부뇌혈류관주적감저,왕기시액협、섭협화정협。③2형DM환자적뇌혈류관주현상우액협국부뇌혈류(rCBF)치분별여WMS중적루가항、리해항정정비상관,여WCST중적견지성착오(%)성부상관;우섭협rCBF치여위씨기억량표중적배수항정정상관。결론 ①혈당공제교호、무반복저혈당발작적2형DM환자잉연존재중추신경계통손해,림상표현위기억력、주의력감퇴,추리판단급개괄능력하강등인지기능손해。②2형DM환자존재불동정도적액、섭、정협혈류관주감저,병차액섭협적혈류관주여기억력、판단력、개괄력、사유적령활성유상관관계。
Objective To investigate the characteristic rCBF abnormalities and the relationship between rCBF and cognitive disorders in type 2 diabetes mellitus patients. Methods The study subjects were 11 middle aged, glycemic controlled type 2 diabetes mellitus patients. Age range of type 2 diabetes mellitus patients was 46~59 years.Eleven age-, sex-, education- and occupation- matched normal controls (age range 41~58 years) were studied under identical conditions. Cognitive functions were evaluated by Wechsler Memory Scale (WMS), Trail Marking Test A and Wisconsin Card Sorting Test (WCST),respectively.99Tcm-ECD (ethylcysteinate dimer) SPECT imaging was performed on all patients and normal controls. Results ①Cognitive test scores of type 2 diabetes mellitus patients were lower than that of normal controls. Diabetic patients were scored lower in memory test than controls (accumulation adding, visual recognition, learning and total memory quotient of WMS, P<0.05). Type 2 diabetes mellitus patients needed much more time to complete the trail marking test (74.2 s vs. 48.7 s). WCST scores were significantly different between two groups. ②The rCBF values of frontal, temporal and parietal lobe were decreased significantly in type 2 diabetes mellitus patients. ③For type 2 diabetes mellitus patients, there was a correlation between rCBF values of right frontal lobe and adding, understanding scores of WMS (positively correlated), persevarative errors(%) of WCST (negatively correlated). The rCBF values of right temporal lobe were positively correlated with inverted counting. Conclusions ①Impairments of central nervous system are existed in glycemic controlled (lack of repeated hypoglycemia) type 2 diabetes mellitus patients. Abnormalities in CNS can express as cognitive dysfunction,such as decrement of memory, attention, thinking and conceptual reasoning abilities. ②Hypoperfusions of frontal, temporal and parietal cortex can be identified in patients of middle aged type 2 diabetes mellitus patients. Decreased perfusion of right frontal and temporal cortex may associate with memory, thinking flexibility impairment.