摘要
作者将２９例老年性痴呆（ＡＤ）和多发梗塞性痴呆（ＭＩＤ）患者先后二次脑ＣＴ结果进行临床对照研究，发现５０％的ＡＤ患者第二次ＣＴ显示由单一的脑萎缩转变为萎缩与梗塞相并存的混合性损害，ＭＩＤ者由梗塞转为混合性损害的达６０％，二组疾病二次ＣＴ诊断变化率为５１．７％。分析表明，病程越长，混合性损害的发生机会越多，与二次检查间隔时间长短无明显关联。混合性损害者易出现神经系统体征，认知功能障碍更较严重。作者认为，仅以一次ＣＴ结果下诊断有片面性，重视病史特点及临床表现更重要。
Objective:To improve the differential diagnosis of dementia by using consecutive CT scan examinations.Method:The first brain CT results of 29 subjects with Alzheimers disease (AD) and multi infarct dementia (MID) were compared with their second CT scans.Results:The second CT scans revealed that simple brain atrophy shown by the first CT scans changed into mixed atrophy and infarction in 50% patients with AD.In 60% of MID patients,infarction developed into mixed infarction and atrophy.The likelihood of developing into mixed pathologies increased significantly with the duration of disease,but not with the interval between the 2 CT examinations.Patients with mixed pathologies exhibited more neurological signs and cognitive impairment.Discussion:Brain CT examinations are insufficient for the differential diagnosis of the subtypes of dementia.History and clinical examination are more important.
出处
《临床精神医学杂志》
1997年第1期3-5,共3页
Journal of Clinical Psychiatry
