上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (8): 917-.doi: 10.3969/j.issn.1674-8115.2018.08.010

• 论著·临床研究 • 上一篇    下一篇

阿尔茨海默病的脑微出血特征研究

吴依娜 1, 2，庄惠翔 3，李钒 3，刘园园 1, 2，严峰 1, 2，史琰琛 1, 2，王静华 1, 2，张建业 1，刘满华 3，王金红 1，肖世富 1, 2，王涛 1, 2   

  1. 1. 上海交通大学医学院附属精神卫生中心老年精神科，上海 200030；2. 上海交通大学阿尔茨海默病诊治中心，上海 200025；3. 上海交通大学电子信息与电气工程学院仪器科学与工程系，上海 200240
  • 出版日期:2018-08-28 发布日期:2018-09-11
  • 通讯作者: 王涛，电子信箱：wtshhwy@163.com。
  • 作者简介:吴依娜（1995—），女，硕士生；电子信箱： 2572445263@qq.com。
  • 基金资助:
    国家自然科学基金（ 81571298）；上海市浦江人才计划（ 17PJD038）；上海市卫生系统优秀人才培养计划（优秀学科带头人）（2017BR054）；上海市教育委员会高峰高原学科建设计划（ 20172029）；上海交通大学医学院转化医学协同创新中心合作研究项目（ TM201728）

Characteristic of brain microbleeds in Alzheimers disease

WU Yi-na1, 2, ZHUANG Hui-xiang3, LI Fan3, LIU Yuan-yuan1, 2, YAN Feng1, 2, SHI Yan-chen1, 2, WANG Jing-hua1, 2, ZHANG Jian-ye1, LIU Man-hua3, WANG Jinhong1, XIAO Shi-fu1, 2, WANG Tao1, 2   

  1. 1. Geriatric Psychiatry Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2. Alzheimer Disease and Related Disorders Center of Shanghai Jiao Tong University, Shanghai 200025, China; 3. Department of Instrument Science and Engineering, Shanghai Jiao Tong University School of Electronic Information and Electrical Engineering, Shanghai 200240, China
  • Online:2018-08-28 Published:2018-09-11
  • Supported by:
    National Natural Science Foundation of China, 81571298; Shanghai Pujiang Plan, 17PJD038; Shanghai Health System Excellent Talent Training Program (Excellent Subject Leader), 2017BR054; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Support, 20172029; Collaborative Innovation Center for Translational Medicine of Shanghai Jiao Tong University School of Medicine Project, TM201728

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摘要： 目的 ·研究不同认知功能水平老人之间的脑微出血差异。方法 ·以 18例阿尔茨海默病患者（ AD组）、 28例遗忘型轻度认知功能损害患者（ aMCI组）以及 30例志愿入组的年龄匹配的正常对照老人（ NC组）为研究对象。利用磁敏感加权成像技术，寻找并记录脑微出血点的数量及位置，勾画出左右大脑的额叶、颞叶、顶叶、枕叶、丘脑等与认知功能密切相关的脑区。 χ2检验分析各组微出血点例次和各脑区及全脑存在微出血点例次的组间差异，并对以上各脑区及全脑的微出血点数量进行组间方差分析。结果 ·对脑区存在微出血点例次的 χ2检验中， AD组与 NC组在额叶（ P0.005）、颞叶（ P0.005）和全脑（ P0.004），aMCI组与 NC组在额叶（ P0.048），3组间在额叶（ P0.006）、颞叶（ P0.006）和全脑（ P0.016）差异均具有统计学意义。对微出血点数量的方差分析中， AD组与 NC组在额叶（ P0.004）、颞叶（ P0.049），aMCI组与 NC组在额叶（ P0.044），3组间在额叶（ P0.016）、颞叶（P0.038）和全脑（P0.048）差异均具有统计学意义。结论 ·阿尔茨海默病患者较正常对照老人在额叶和颞叶存在较重的脑微出血表现，脑微出血的量化有望成为阿尔茨海默病诊断的候选指标。

关键词: 轻度认知功能损害, 阿尔茨海默病, 磁敏感加权成像, 脑微出血

Abstract:

Objective · Toevaluatethedifferencesof brain microbleedsamongAlzheimer′s disease(AD),amnesia mild cognitiveimpairment (aMCI)and normal control (NC). Methods · Eighteen AD patients, 28 aMCI patients and 30 age-matched NC were recruited in the study. The location and number of microbleeds was recorded in the brain according to the susceptibility-weighted images. The bilateral frontal lobe, parietal lobe, occipital lobe, temporal lobe, and thalamus were manually mapped on 3D-MR imaging. The number of cases with microbleeds and the number of microbleeds in each lobe were calculated and compared among three groups using the chi-square test and ANOVA. Results · Significant differences on case number with microbleeds were found betweenAD group and NC group in the frontal lobe (P0.005), the temporal lobe (P0.005) and whole brain (P0.004), and between aMCI group and NC group in the frontal lobe (P0.048). It also showed significant differences among three groups in the frontal lobe (P0.006), the temporal lobe (P0.006) and whole brain (P0.016). For the microbleeds counts, significant differences were found betweenAD group and NC group in the frontal lobe (P0.004) and the temporal lobe (P0.049), and between AD group and NC group in the frontal lobe (P0.044). It also had significant differences among three groups in the frontal lobe (P0.016), the temporal lobe (P0.038) and whole brain (P0.048). Conclusion · The AD group has more significantmicrobleeds in frontal and parietal lobes incomparison toNC group.The quantization of cerebral microbleedsmay be apotential biomarker for AD diagnosis.

Key words: mild cognitive impairment (MCI), Alzheimer&, prime, sdisease, susceptibility-weighted image (SWI), brainmicrobleed

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