范存庚
[摘要] 目的 探討CT影像學(xué)對血管性癡呆患者的診斷價(jià)值。 方法 選取本院2018年1月~2019年10月期間接診的78例經(jīng)CT影像學(xué)檢查確診為血管性癡呆的患者作為觀察組,選取同期的78例非癡呆性腦卒中患者作為對照組,同樣接受CT影像學(xué)檢查,使用簡易智力狀態(tài)檢查量表(MMSE)和日常生活能力評定量表(ADL)對比兩組患者認(rèn)知功能和生活自理能力,對比兩組患者CT影像學(xué)檢查表現(xiàn)及兩組患者的腦萎縮率。 結(jié)果 觀察組患者的MMSE評分和ADL評分分別為(21.65±1.45)分和(40.25±5.36)分,對照組患者的MMSE評分和ADL評分分別為(27.20±1.66)分和(60.78±3.26)分,觀察組評分明顯低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);兩組患者的CT影像學(xué)表現(xiàn)結(jié)果表明,觀察組患者的腦梗死面積比對照組大,部分患者在腦出血后出現(xiàn)梗死,病變的位置以皮質(zhì)和皮質(zhì)下為主,雙側(cè)和左側(cè)為主要傾向;觀察組患者的腦萎縮率達(dá)到83.33%,明顯高于對照組的12.82%,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。 結(jié)論 CT影像學(xué)檢查可以清晰且準(zhǔn)確的反映出血管性癡呆患者的病灶位置和腦萎縮情況等,臨床診斷價(jià)值較高,是一種高效、可靠的血管性癡呆檢查方法,值得推廣并應(yīng)用。
[關(guān)鍵詞] CT影像學(xué);血管性癡呆;腦萎縮;腦卒中
[中圖分類號] R749.1? ? ? ? ? [文獻(xiàn)標(biāo)識碼] B? ? ? ? ? [文章編號] 1673-9701(2020)16-0118-03
Diagnostic value of CT imaging in patients with vascular dementia
FAN Cungeng
Department of Medical Imaging, Ganzhou People's Hospital in Jiangxi Province, Ganzhou? ?341000, China
[Abstract] Objective To explore the diagnostic value of CT imaging in patients with vascular dementia. Methods 78 patients diagnosed with vascular dementia by CT imaging in our hospital from January 2018 to October 2019 were selected as the observation group. 78 non-dementia stroke patients during the same period were selected as the control group, and they also underwent CT imaging examination. The cognitive function and life self-care ability between the two groups were compared by using the Simple Mental State Examination Scale(MMSE) and the Daily Living Ability Assessment Scale(ADL). And the CT imaging examination performance and the brain atrophy rate between the two groups were compared. Results The MMSE score and ADL score of the observation group were(21.65±1.45) and(40.25±5.36) points respectively, while the MMSE score and ADL score of the control group were(27.20±1.66) and(60.78±3.26) points. The score of the observation group was significantly lower than that of the control group, with statistically significant difference(P<0.05). CT imaging results of the two groups showed that the cerebral infarction area of the observation group was larger than that of the control group, and some patients had infarction after cerebral hemorrhage. The location of the lesion was mainly cortex and subcortex, and the main tendency was bilateral and left. The brain atrophy rate of the observation group reaches 83.33%, which was significantly higher than that of the control group(12.82%), and the difference was statistically significant(P<0.05). Conclusion CT imaging can clearly and accurately reflect the location of lesions and brain atrophy in patients with vascular dementia, with relatively high clinical diagnosis value. It is an efficient and reliable vascular dementia examination method, which is worthy of promotion and application.
本次研究結(jié)果表明,觀察組患者的MMSE評分、ADL評分明顯低于對照組,表明觀察組患者均表現(xiàn)出明顯的癡呆癥狀。觀察組患者的病灶位置多數(shù)在皮質(zhì)、皮質(zhì)下,具有比較明顯的左側(cè)和雙側(cè)傾向,并且梗死的面積比較大,與對照組患者具有比較大的差異,觀察組患者腦萎縮率為83.33%,對照組腦萎縮率為12.82%,兩組數(shù)據(jù)對比差異明顯,具有統(tǒng)計(jì)學(xué)意義(P<0.05)。由此可見,CT影像學(xué)在診斷血管性癡呆上,具有比較高的診斷價(jià)值,具有良好的應(yīng)用效果,應(yīng)該得到更為廣泛的推廣與臨床應(yīng)用。
綜上所述,CT影像學(xué)檢查可以清晰且準(zhǔn)確的反映出血管性癡呆患者的病灶位置和腦萎縮情況等,相關(guān)檢查和診斷的準(zhǔn)確率比較高,并且檢查費(fèi)用相對較低,經(jīng)濟(jì)適用,臨床診斷價(jià)值比較高,是一種高效、可靠的血管性癡呆檢查方法,值得推廣并應(yīng)用。
[參考文獻(xiàn)]
[1] 鐘必武,王宗明,王靜.探討CT影像學(xué)對于血管性癡呆的診斷價(jià)值[J].中國實(shí)用醫(yī)藥,2019,14(34):95-96.
[2] 劉玉濤,許予明,高遠(yuǎn),等.阿爾茨海默病、血管性癡呆及額顳葉變性患者的腦MRI及CT平掃影像學(xué)特征分析[J].中國CT和MRI雜志,2018,(5):25.
[3] 吳佳慧,劉劍剛,李浩,等.阿爾茨海默病和血管性癡呆的病理機(jī)制及相關(guān)臨床研究比較[J].浙江醫(yī)學(xué),2019,(11):121-122.
[4] 丁曉燕,咸海亮.頭顱核磁共振在診斷腦血管性癡呆中的臨床價(jià)值[J].影像研究與醫(yī)學(xué)應(yīng)用,2018,(14):101.
[5] 田金洲,解恒革,秦斌,等.適用于中國人群的血管性癡呆篩查和診斷框架[J].中華內(nèi)科雜志,2019,58(1):10.
[6] 李維.探討頭顱血管磁共振在腦血管性癡呆患者中臨床診斷價(jià)值[J].影像研究與醫(yī)學(xué)應(yīng)用,2018,(5):15-16.
[7] 陳赟,何志聰,范燕明,等.簡明精神狀態(tài)量表聯(lián)合蒙特利爾認(rèn)知評估量表在血管性癡呆認(rèn)知功能障礙中的初步應(yīng)用[J].中國醫(yī)學(xué)創(chuàng)新,2019,16(4):83-87.
[8] 阮世旺.血管性癡呆危險(xiǎn)因素及影像學(xué)特征[J].中國實(shí)用神經(jīng)疾病雜志,2017,(7):30.
[9] 相振宇,蔡強(qiáng),李軍東,等.頸內(nèi)動(dòng)脈顱內(nèi)段鈣化與腔隙性腦梗死影像學(xué)相關(guān)性研究[J].中國藥物與臨床,2017, 17(11):1631-1633.
[10] 羅燕.血管性癡呆的診斷和治療進(jìn)展[J].國際神經(jīng)病學(xué)神經(jīng)外科學(xué)雜志,2017,(5):147.
[11] 顧雨鋮,徐運(yùn).腦小血管病與血管性認(rèn)知損害:關(guān)注神經(jīng)影像學(xué)[J].國際腦血管病雜志,2017,25(3):244-250.
[12] 王玲,田榮華.磁共振成像與顱腦CT在老年多發(fā)性腦梗死診斷中的對比研究[J].中外醫(yī)學(xué)研究,2019,17(1):71-72.
[13] 吳佳慧,劉劍剛,李浩,等.阿爾茨海默病和血管性癡呆的病理機(jī)制及相關(guān)臨床研究比較[J].浙江醫(yī)學(xué),2019(11):20-21.
[14] QL Zhang,P Lu,JW Zhang.Association of serum lipoprotein -associated phospholipase A2 with vascular dementia after ischemic stroke[J].Zhonghua Yi Xue Za Zhi,2018, 98(15):1171-1175.
[15] 王道仁.CT與磁共振成像對多發(fā)性腦梗死診斷價(jià)值對比研究[J].中國藥物與臨床,2019,(11):1803-1804.
(收稿日期:2020-01-09)