Alzheimer’s disease (AD) is a critical health issue worldwide that has a negative impact on patients’ quality of life, as well as on caregivers, society, and the environment. Positron emission tomography (PET)/computed tomography (CT) and neuropsychological scales can be used to identify AD and mild cognitive impairment (MCI) early, provide a differential diagnosis, and offer early therapies to impede the course of the illness. However, there are few reports of large-scale 11 C-PIB-PET/CT investigations that focus on the pathology of AD and MCI. Therefore, further research is needed to determine how neuropsychological test scales and PET/CT measurements of disease progression interact.

目的:探索11C-匹兹堡化合物B正电子发射断层扫描成像([N-methyl-11C]-2-(4-methylaminophenyl)-6-hydroxyben-zothiazole,positron emission tomography,"C-PIB-PET/CT)与神经心理量表在轻度认知功能障碍(mild cognitive impairment,MCI)和阿尔茨海默病(Alzheimer's disease,AD)的关系.方法:选取吉林大学中日联谊医院神经内科2018年1月至2020年12月符合纳入标准的阿尔茨海默病及轻度认知功能障碍门诊及住院患者27例,收集患者一般资料、神经心理测试量表评分和11C-PIB-PET/CT成像,使用pMOD软件对患者11C-PIB-PET/CT成像进行处理,得到患者各脑区11C-PIB的标准摄取值比(standardized uptake value ratio,SUVR),组间对比得到显著差异的脑区,对所有患者具有显著差异的脑区SUVR与神经心理测试量表进行统计学分析.结果:①AD组SUVR均值高于MCI组SUVR均值,组间差异具有统计学意义(P＜0.01).②2组患者SUVR值具有统计学差异(P＜0.01)的脑区为:左侧额下回(P=0.009)、左侧额上回(P=0.008)、左侧海马旁回及周围回(P=0.005)、右侧海马旁回及周围回(P=0.002)、左侧梭形回(P=0.002)、右侧梭形回(P=0.003)、左侧中央后回(P=0.003)、右侧楔叶(P=0.008)、左侧壳核(P=0.007)、右侧壳核(P=0.003)、右侧苍白球(P=0.006)、右侧扣带回前部(P=0.004).③进一步将所有患者差异显著的脑区SUVR值与简易智能测试量表评分(mini-mental state examination,MMSE)及蒙特利尔认知评估(Montreal cognitive assessment,MoCA)行Pearson相关性分析.其中,左侧额上回(r=-0.454,P=0.029)、左侧海马旁回及周围回(r=-0.439,P=0.036)、左侧梭形回(r=-0.421,P=0.045)、左侧中央后回(r=-0.482,P=0.020)SUVR 值与 MMSE 评分呈负相关(P＜0.05).左侧额上回(r=-0.430,P=0.040)、左侧海马旁回及周围回(r=-0.418,P=0.047)、左侧梭形回(r=-0.454,P=0.030)、左侧中央后回(r=-0.477,P=0.021)、左侧壳核(r=-0.422,P=0.045)、右侧壳核(r=-0.419,P=0.047)SUVR值与MoCA评分呈负相关(P＜0.05).结论:①AD组患者脑内11C-PIB的SUVR值显著高于MCI组患者.②AD组与MCI组患者多个脑区SUVR值具有显著差异.③额上回(左)、海马旁回及周围回(左)、梭形回(左)、中央后回(左)、壳核(左、右)部位Aβ蛋白沉积水平与认知功能损害相关.研究结果可为AD的早期识别诊断提供一定的影像学证据.

急性脑梗死多发生于老年人,其病因多种多样,主要包括大脑动脉粥样硬化、心源性栓塞和小动脉闭塞.针对不同病因的治疗和预防不同,因此,对于不同类型的脑梗死病因诊断非常重要.TOAST分型为目前国际最为广泛应用的病因分型.目前已知低密度脂蛋白胆固醇(LDL)与动脉硬化明显相关[1],血清游离脂肪酸与高血压病、冠心病、动脉粥样硬化、糖尿病等疾病有关.血清游离脂肪酸与LDL存在一定相关性[2],但血游离脂肪酸与脑血管病的关系尚未明确.目前仅有少量关于血清游离脂肪酸与脑血管病相关性的研究.研究表明不同类型的游离脂肪酸对脑梗死的影响不同[3].本研究通过分析血LDL、硬脂酸、花生四烯酸、总饱和脂肪酸在不同类型的脑梗死中的差异表达,以期对不同类型脑梗死的诊断和治疗提供帮助.

Aim: Construct a clinical predictive model based on easily accessible clinical features and imaging data to identify patients 65 years of age and younger with mild cognitive impairment(MCI) who may progress to Alzheimer's disease(AD). Methods: From the ADNI database, patients with MCI who were less than or equal to 65 years of age and who had been followed for 6-60 months were selected.We collected demographic data, neuropsycholog-ical test scale scores, and structural magnetic images of these patients. Clinical characteristics were then screened, and VBM and SBM analyses were performed using structural nuclear magnetic images to obtain imaging histology characteristics. Finally, predictive models were constructed combining the clinical and imaging histology characteristics. Results: The constructed nomogram has a cross-validated AUC of 0.872 in the training set and 0.867 in the verification set, and the calibration curve fits well.We also provide an online model-based forecasting tool. Conclusion: The model has good performance and uses convenience,it should be able to provide assistance in clinical work to screen relatively young MCI patients who may progress to AD. (c) 2021 Elsevier Ltd. All rights reserved.