本文選題：血管疾病　切入點：蒙特利爾認知評估量表　出處：《安徽醫(yī)科大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的應用單光子發(fā)射計算機斷層核素顯像(SPECT)探討血管性認知障礙無癡呆(VCIND)的局部腦血流量(rCBF)及放射性比值(RAR)的關系并分析MoCA和MMSE分數(shù)與各腦區(qū)的相關性。 方法VCIND患者45例,其中男性20例,女性25例,同期年齡和性別相匹配的15例健康體檢合格者為對照組,其中男性6例,女性9例。對所有研究對象進行一般檢查、神經(jīng)功能評定和腦SPECT檢查。 結果VCIND組患者與對照組相比雙側額葉、左側頂上小葉、左側丘腦rCBF及RAR值明顯降低(P＜0.05),在VCIND組內(nèi)左側額葉、左側頂上小葉、左側丘腦均較右側額葉、右側頂上小葉、右側丘腦rCBF及RAR值也明顯降低(P＜0.05)。VCIND組MoCA子項中視空間與執(zhí)行功能、抽象、注意、延遲記憶及MMSE子項中執(zhí)行功能、回憶明顯低于對照組(P＜0.05)。MoCA子項視空間與執(zhí)行功能與右額葉、雙側頂上小葉、雙側顳葉內(nèi)側RAR值呈正相關;抽象與左額葉、左丘腦RAR值呈正相關;延遲記憶與左頂上葉、雙側顳葉內(nèi)側、左丘腦RAR值呈正相關;;注意與左顳葉內(nèi)側、左丘腦RAR值呈正相關MoCA總分與雙側額葉、左丘腦RAR值呈正相關。MMSE子項執(zhí)行功能與右額葉RAR值呈正相關;回憶與左顳葉內(nèi)側RAR值呈正相關;MMSE總分與右額葉RAR值呈正相關。 結論①S PECT腦灌注顯像對于早期發(fā)現(xiàn)VCIND患者具有極其重要的意義;②左側半球損害早于右側,可能是VCIND患者重要的特點之一;③M oCA和MMSE分數(shù)與各腦區(qū)之間有一定的相關性;④MoCA量表在早期發(fā)現(xiàn)VCIND和預測預后優(yōu)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.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R749.1

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