轻度认知障碍及阿尔茨海默病的sMRI分析

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摘要目的探讨轻度认知障碍（MCI）和阿尔茨海默病（AD）各脑区结构性磁共振（sMRI）的特征，发现特征性指标，从而为早期诊断提供帮助。方法随机选取2014年8月~2015年7月ADNI数据库中编号为4018~5210的研究对象543例，根据阿尔茨海默病神经影像学计划（ADNI）数据库诊断标准分为四组：认知功能正常组（CN）139例，早期轻度认知障碍组（EMCI）220例，晚期轻度认知障碍组（LMCI）108例，AD组76例，获得研究对象简易精神状态评价量表（mini-mental state examination，MMSE）及272项结构性MRI（structural MRI，sMRI）数据。将sMRI数据进行单因素方差分析、多重比较、非参数检验、配对比较分析、多元线性回归分析等统计学方法，发现具有疾病预测意义的特征指标。结果 272项sMRI数据分析，获得CN、EMCI、LMCI、AD四组间差异均有统计学意义的指标28项，其中22项为左右脑区配对部位。左右脑区进行配对比较分析，左半球萎缩程度更严重。28项sMRI数据与MMSE经多元线性回归分析得出，左海马下托体积对MMSE量表评分影响最大。结论随着MCI发病向AD进展，脑萎缩程度逐渐递增，且左半球在疾病进展中萎缩程度更严重，主要集中在边缘系统。其中，左海马下托体积对MMSE量表评分影响最大。

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	齐雪丹
	许凡宇
	范炤

关键词 ：阿尔茨海默病, 轻度认知障碍, 结构性磁共振, 简易精神状态评价量表, 配对比较分析, 多元线性回归分析

Abstract：Objective To investigate the characteristics of structural magnetic resonance imaging(sMRI)of mild cognitive impairment(MCI)and Alzheimer disease(AD)in differentbrain regions,and to find out the characteristic indexes so as to provide assistance for early diagnosis.Methods Altogether 543 patients whose number ranged from 4018 to 5210 in the Alzheimer Disease Neuroimaging Initiative(ADNI)database from August 2014 July 2015 were randomly selected as the object of this research and divided into four groups according to the ADNI database diagnostic standards:139 cases in normal cognitive function group(CN),220 cases in early mild cognitive impairment group(EMCI),108 cases in later mild cognitive impairment group(LMCI)and 76 cases in AD group.Mini-Mental State Examination(MMSE)and 272 sMRI data of all the subjects were acquired.And multiple statistics methods were used,including the single-factor variance analysis,multiple comparison,nonparametric test,paired comparison analysis and multiple linear regression analysis,to discover the characteristic index that can make prediction of disease.Results The analysis results showed that among 272 sMRI data,28 indexes of CN group,EMCI group,LMCI group and AD group had statistically significant difference,of which there were 22 indexes in the pairing locations of the left and right brain region.Through analysis of the left and right brain regions by using paired comparison,a more serious atrophy was seen in the left hemisphere.According to the multiple linear regression analysis of 28 sMRI data and MMSE,the lower volume of the left hippocampus played the biggest influence on the MMSE score.Conclusion With the development of MCI into AD,the degree of brain atrophy is gradually increasing,and the left hemisphere is more severe in the progression of disease,among which,the lower volume of the left hippocampal has the greatest influence on the MMSE score.

Key words： Alzhe im er disease Mild cognitive impairment Structural magnetic resonance imaging Mini-mental state rating scale Paired comparative analysis Multiple linear regression analysis

基金资助:山西省留学回国人员科技活动择优资助项目（晋人社厅函[2016]97号）

引用本文:

齐雪丹;许凡宇;范炤. 轻度认知障碍及阿尔茨海默病的sMRI分析[J]. 中国当代医药, 2017, 24(8): 9-13转26.
QI Xue-dan;XU Fan-yu;FAN Zhao. Analysis of sMRI features of mild cognitive impairment and Alzheimer disease. 中国当代医药, 2017, 24(8): 9-13转26.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I8/9

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