经颅多普勒超声检测阿尔茨海默病患者脑血流动力学变化特点的研究

摘要

目的 应用经颅多普勒(TCD)检测阿尔茨海默病(AD)患者脑血流动力学变化,探讨该变化与AD患者认知功能受损之间的联系.方法 选取AD患者40例(AD组)和认知功能正常且年龄与之匹配的老年患者43例(对照组),应用TCD检查两组所探测颅内动脉的平均血流速度(MFV)和搏动指数(PI),并对其结果进行对比;同时分析其与认知功能的关系,ROC曲线计算各血流动力学参数曲线下面积.结果 AD组所探测颅内动脉MFV值均较对照组减低,PI值均较对照组升高,差异均有统计学意义(均P0.7.结论 颅内动脉MFV降低和PI升高是AD患者脑血流动力学的变化特点,该变化的程度与认知功能受损的程度相关.TCD不仅对AD具有一定的诊断价值,还可评估AD患者的认知功能,具有重要临床应用价值.%Objective To evaluate the cerebral hemodynamic changes of Alzheimer's disease(AD) by transcranial Doppler ultrasound(TCD),and to explore into the relationship between cognition impairment and these changes.Methods Forty AD patients and 43 non-demented controls were recruited.TCD was employed to assess the mean flow velocity(MFV) and pulsatility index (PI) of intracranial arterial segments.Comparison of MFV and PI between the two groups were conducted.Pearson correlation analysis was used to detect the relationship between hemodynamic parameters and cognitive function.The area under ROC curve of the hemodynamic parameters was calculated.Results MFV in AD group was lower than that in control group (P<0.05),while PI in AD group was higher than that in control group(P<0.05).MFV was positively related to mini-mental state examination(MMSE) score(r=0.82,P<0.05),while PI was negatively correlated to MMSE score in AD group(r=-0.81,P<0.05). The area under ROC curve showed that the vast majority of the measurements for PI and MFV in the arteries of interest were larger than 0.7.Conclusion Decreased MFV and increased PI are the hemodynamic characteristiccs of AD patients,which is related to the cognition impairment.TCD might have a diagnostic potential and may also evaluate the cognitive level of AD patients.