目的：分析比较阿尔茨海默病（ AD）与血管性痴呆（ VD）患者的认知能力、日常生活能力。方法 AD患者218例（ AD组），VD患者127例（ VD组），应用简易精神状况检查量表（ MMSE量表）评定两组患者的认知能力，应用日常生活能力量表（ ADL量表）评定两组患者日常生活能力。结果 AD组、VD组MMSE量表总分分别为（18．23±6．25）、（18．73±7．64）分，其中延迟回忆分别为（0．66±0．95）、（0．99±1．14）分，听理解分别为（2．78±0．61）、（2．41±0．80）分，两组延迟回忆、听理解比较，P均＜0．01。 AD组ADL量表总分为（32．84±13．34）分，VD组为（35．03±16．96）分，两组比较，P＞0．05。结论 AD与VD总体认知能力、日常生活能力无差异，但VD患者的延迟回忆优于AD患者、AD患者听理解方面优于VD患者。

Background Posterior cortical atrophy (PCA) is a kind of progressive neurodegenerative disease with cortical visual impairment as the first symptom. Because of rare clinical incidence, early onset age, special clinical symptoms and unobvious MRI abnormality, the definitive diagnosis of PCA is difficult. This study used 18F-fluoro-2-deoxy-D-glucose (18F-FDG) PET and 11C-Pittsburgh compound B (11C-PIB) PET for PCA patients with unobvious MRI abnormality, so as to discuss the value of PET in the early diagnosis of PCA. Methods Five patients diagnosed as PCA in our hospital between April 2012 and March 2015 were enrolled in this study. Cognitive function was measured by Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living (ADL) and Clock Drawing Test (CDT). Brain MRI, 18F-FDG PET and 11C-PIB PET were performed to analyze glucose metabolism and perfusion of posterior cortex. Results Neuropsychological tests revealed that the ability of writing, calculating, visuospatial and executive function of all these patients were impaired. Color vision tests showed abnormal results. MRI showed that the posterior atrophy (PA) scores were 0-2 (average 1) on the left side and 0-1 (average 0.80) on the right side. The medial temporal atrophy (MTA) scores were 1-3 (average 1.80) on the left side and 1-4 (average 2) on the right side. The ventricular enlargement (VE) scores were 1-2 (average 1.80) on the left side and 1-2 (average 1.60) on the right side. 18F-FDG PET showed glucose metabolism decreased obviously on bilateral temporo-parieto-occipital cortex, precuneus and cingulate gyrus, and slightly on frontal lobes and subcortical structure. 11C-PIB PET showed radioactive 11C-PIB deposition on bilateral frontal, temporal, parietal and occipital cortex, and the outline of cerebellar cortex was clear. Conclusions For PCA patients whose parietal and occipital cortical atrophy is not obvious on MRI, 18F-FDG PET combined with 11C-PIB PET plays an important role in early diagnosis. DOI: 10.3969/j.issn.1672-6731.2015.08.005