本文選題：阿爾茨海默病 + 帕金森病��； 參考：《臨床放射學雜志》2017年09期

【摘要】：目的初步分析帕金森病(PD)和阿爾茨海默病(AD)基底節(jié)區(qū)及半卵圓中心區(qū)血管周圍間隙擴大(EPVS)的情況及兩者是否存在差異。方法 67例AD患者,平均年齡(70.57±10.44)歲,男32例,女35例;58例PD患者,平均年齡(66.96±8.45)歲,男28例,女30例;60名年齡、性別相匹配的健康老年人,平均年齡(69.83±7.26)歲,男28名,女32名,被納入本次研究。通過觀察MRI T_2WI及T_2FLAIR圖像,分別計數各組基底節(jié)區(qū)及半卵圓中心區(qū)EPVS的數目并進行4級評分。采用SPSS 17.0軟件進行統(tǒng)計學處理,計數資料比較采用單因素方差分析,組間均數比較采用t檢驗,等級資料用Kruskal-Wallis及Kolmogorov-Smirnov Z檢驗分析組間差異。應用Spearman相關分析EPVS與簡易精神狀態(tài)檢查量表(MMSE)評分之間的相關性。P0.05為差異有統(tǒng)計學意義。結果三組間基底節(jié)、半卵圓中心區(qū)EPVS評分均有統(tǒng)計學意義(H值分別為17.91,46.28,P均0.01)。與正常對照組比較,AD組基底節(jié)區(qū)的EPVS評分差異有統(tǒng)計學意義(Z=1.939,P0.001),PD組與對照組及AD組的EPVS評分差異均無統(tǒng)計學差異(Z分別=1.314,0.83,P均0.05);在半卵圓中心區(qū)域,AD組及PD組分別與正常對照組比較EPVS評分差異均有統(tǒng)計學意義(Z=2.786,Z=1.518,P0.05),除此之外,PD組與AD組間評分差異也有統(tǒng)計學意義(Z=1.585,P0.01)。三組間基底節(jié)區(qū)及半卵圓中心區(qū)EPVS累計得分符合正態(tài)分布,AD組總EPVS評分(4.38±1.34)顯著高于PD組(3.55±1.17)(P0.01)。65歲時,AD組與PD組兩者間EPVS評分差異無統(tǒng)計學意義(P0.05),但AD組及PD組EPVS評分均高于正常對照組(P均0.01);65~75歲時,三組間EPVS評分兩兩比較差異均有統(tǒng)計學意義(P0.05);75歲時,三組間EPVS評分兩兩比較差異均有統(tǒng)計學意義(P均0.01)。結論 EPVS是PD和AD患者腦內的微血管改變,而且PD和AD腦內EPVS分布也有所區(qū)別,且隨著年齡的增長,兩者間的差異性逐漸增加。
[Abstract]:Objective to analyze the extent of enlargement of perivascular space in basal ganglia and central semi-oval region of Parkinson's disease (PD) and Alzheimer's disease (AD) and whether there are differences between them. Methods Sixty-seven patients with AD, with an average age of 70.57 鹵10.44 years, 32 males and 35 females, with an average age of 66.96 鹵8.45 years, 28 males and 30 females, with an average age of 69.83 鹵7.26 years, 28 males and 32 females, were enrolled in this study. Was included in this study. By observing the MRI T_2WI and T_2FLAIR images, the number of EPVS in the basal ganglia and the central semi-oval region in each group were counted and graded in 4 grades. SPSS 17.0 software was used for statistical processing. The counting data were compared by single factor ANOVA, the mean of group was analyzed by t test, and the difference between groups was analyzed by Kruskal-Wallis and Kolmogorov-Smirnov Z test. Using Spearman correlation analysis, the correlation between EPVS and MMSE score was statistically significant. Results the EPVS scores of basal ganglia and central semi-oval area in the three groups were significantly higher than those in the control group (P < 0.01). There was no significant difference in EPVS score between AD group and control group and AD group (P < 0.05), and in AD group and PD group, there was no significant difference between AD group and AD group in basal ganglia score of basal ganglia, and there was no significant difference in EPVS score between AD group and control group and AD group, and there was no significant difference in EPVS score between AD group and PD group in central region of semicircle, and there was no significant difference in EPVS score between AD group and control group and AD group (P < 0.05). There were significant differences in EPVS score between normal control group and control group. In addition, there was significant difference in EPVS score between PD group and AD group. The cumulative EPVS scores of basal ganglia and centroid ovale in AD group (4.38 鹵1.34) were significantly higher than those in AD group (3.55 鹵1.17)(P0.01).65 years old) and PD group (P 0.05), but EPVS scores in AD group and PD group were not significantly different. All of them were higher than those in the normal control group (P < 0.01) at the age of 65 ~ 75 years. There were significant differences in EPVS scores between the three groups at 75 years old, and there were significant differences in EPVS scores between the three groups (P < 0.01). Conclusion EPVS is a microvascular change in the brain of PD and AD patients, and the distribution of EPVS in PD and AD is different, and the difference between PD and AD increases with age.
【作者單位】： 大連醫(yī)科大學附屬第一醫(yī)院放射科;
【分類號】：R445.2;R742.5;R749.16

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