CAJ | 학술논문

目的探讨不同程度阿尔茨海默病(AD)患者大脑异生皮质区CT血流灌注水平及其与精神行为的相关性.方法随机选择60例AD患者及30例健康老人,进行简易智能状态量表(MMSE)检查,并选取海马区层面进行CT血流灌注扫描,获得感兴趣区的血流灌注值.另用临床痴呆量表将AD组分为轻、中、重度3组,并通过阿尔茨海默病行为病理评定量表(BEHAVE-AD)检查.结果 AD患者行为紊乱最为多见,其次为妄想,发生率分别为81.7%及58.3%.重度组行为紊乱程度明显高于中、轻度组.中度组妄想分明显高于轻度组(P＜0.05).AD组与健康组的双侧海马结构、内嗅区及右前下托的达峰时间(TTP)比较差异均有显著统计学意义(P＜0.01).中度组TTP分别为(21.70±7.95)s,(21.46±7.40)s,(21.62±7.25)s,(21.15±6.83)s,(21.26±7.25)s,较轻度组、健康组明显延长(P＜0.05).相关分析显示异生皮质TTP与行为紊乱、妄想呈正相关(P＜0.05),与情感障碍呈负相关(P＜0.05).结论 AD患者出现行为紊乱、妄想以及情感障碍与大脑异生皮质区慢性缺血导致神经传导障碍有一定关系.
목적 탐토불동정도아이자해묵병(AD)환자대뇌이생피질구CT혈류관주수평급기여정신행위적상관성.방법 수궤선택60례AD환자급30례건강노인,진행간역지능상태량표(MMSE)검사,병선취해마구층면진행CT혈류관주소묘,획득감흥취구적혈류관주치.령용림상치태량표장AD조분위경、중、중도3조,병통과아이자해묵병행위병리평정량표(BEHAVE-AD)검사.결과 AD환자행위문란최위다견,기차위망상,발생솔분별위81.7%급58.3%.중도조행위문란정도명현고우중、경도조.중도조망상분명현고우경도조(P＜0.05).AD조여건강조적쌍측해마결구、내후구급우전하탁적체봉시간(TTP)비교차이균유현저통계학의의(P＜0.01).중도조TTP분별위(21.70±7.95)s,(21.46±7.40)s,(21.62±7.25)s,(21.15±6.83)s,(21.26±7.25)s,교경도조、건강조명현연장(P＜0.05).상관분석현시이생피질TTP여행위문란、망상정정상관(P＜0.05),여정감장애정부상관(P＜0.05).결론 AD환자출현행위문란、망상이급정감장애여대뇌이생피질구만성결혈도치신경전도장애유일정관계.
Objective To explore the relationship between behavioral psychological symptoms in Alzheimer' s dementia(AD) patients and region-specific alterations in cerebral blood flow. Methods 60 patients with AD randomly selected from a psychiatric outpatient department and 30 randomly selected healthy elderly community controls were administered the Mini-Mental State Exam (MMSE). All subjects underwent a perfusion CT scan to assess blood perfusion in brain regions of interest. The AD subjects were administered the behavioral patholigy in alzheimer' s disease(BEHAVE-AD) Rating Scale classified as mild, moderate or severe based on the results of the Clinical Dementia Rating scale. Results The most incidence was conduct disorder and the next was delusion.The score was 81.7% and 58.3% in turn. The conduct disorder score was higher in the severe demented group than in the mildly and moderate demented group(P＜0. 05). The delusion score was higher in the moderate demented group than that in the mildly demented group(P＜0.05). The time to peak(TTP)scores in the four groups of subjects were significantly different in the bilateral hippocampal formation, anteroinferior subiculum and entorhinal area. The TTP score was significantly higher in the moderately demented group than that in the mildly demented group and the control group(P＜0. 05 ). Correlation analysis identified a positive correlation between conduct disorder, delusions and TTP in cerebral heteroplasia cortex (P ＜ 0. 05 ), also identified a negative correlation between mood disorder and TTP(P＜0. 05 ). Conclusion The conduct disorder,delusions and mood disorder in AD are associated with the chronicity ischemia of cerebral heteroplasia cortex leading to neural conduction disorders.