曹玉林 侯洪涛 魏福全 李嘉鹏 孙胜禄

[摘要] 目的 探讨静息态功能磁共振在阿尔茨海默病患者临床诊断中的应用。 方法 选取2019年5月至2020年10月因阿尔茨海默病来我院接受治疗的60例患者为研究组，并选取同时期来我院体检的60名健康者为对照组。两组人员均接受静息态功能磁共振检测，分析并比较其检测结果。 结果 研究组的MMSE为（19.5±2.9）分、AVLT即刻回忆为（2.8±0.9）分、AVLT延迟回忆为（0.8±0.7）分，均低于对照组的（28.6±1.8）分、（5.7±0.9）分、（5.5±1.0）分，差异有统计学意义（P<0.05）;与对照组相比，研究组中与左侧丘脑功能连接明显降低的区域为右侧后/中扣带回、左侧前额叶内侧面以及右侧额上回/前额叶内侧面;而研究组与右侧丘脑功能连接明显降低的区域为右侧额上回/前额叶内侧面、右侧后/中扣带回以及右侧海马。 结论 对阿尔茨海默病患者采用静息态功能磁共振检测，能够对其丘脑功能连接异常情况进行准确显示，利于对患者病情确诊及治疗方案的有效实施。

[关键词] 静息态功能磁共振;阿尔茨海默病;临床诊断;简易精神量表

[中图分类号] R745.1;R445.2          [文献标识码] B          [文章编号] 1673-9701（2021）32-0133-04

[Abstract] Objective To explore the application of resting-state functional magnetic resonance imaging（fMRI） in the clinical diagnosis of Alzheimer's disease. Methods A total of 60 patients with Alzheimer's disease who were admitted to our hospital for treatment from May 2019 to October 2020 were selected as the study group，and 60 healthy people who were admitted to our hospital for physical examination during the same period were selected as the control group. Resting-state fMRI was performed in both groups， and the results were analyzed and compared. Results The MMSE score （19.5±2.9）points，AVLT immediate recall score （2.8±0.9）points and AVLT delayed recall score （0.8±0.7）points in the study group were all lower than those in the control group， whose MMSE score was（28.6±1.8）points， AVLT immediate recall score was （5.7±0.9）points and AVLT delayed recall score was（5.5±1.0）points， the differences between the two groups were statistically significant（P<0.05）. In the study group，functional connections to the left thalamus were significantly decreased in the right posterior/middle cingulate gyrus， the left medial prefrontal cortex， and the right superior frontal gyrus/medial prefrontal cortex compared to the control group. Besides， the functional connections in the study group to the right thalamus were significantly reduced in the right superior frontal gyrus/medial prefrontal lobe， right posterior/middle cingulate gyrus， and right hippocampus. Conclusion Resting-state fMRI can accurately display abnormal thalamic functional connectivity in patients with Alzheimer's disease，which is conducive to the diagnosis of patients' disease and the effective implementation of treatment plans.

[Key words] Resting-state functional MRI; Alzheimer's disease; Clinical diagnosis; Mini-mental state examination

阿爾茨海默病（Alzheimer's disease，AD）主要是以进行性智力减低为特征的一类中枢神经系统变性疾病，该疾病在老年人群中较为常见，严重影响老年患者的生存质量水平，由于目前尚缺乏有效的治疗措施，因此，早期诊断至关重要[1-2]。近年来，伴随着影像学技术的进步与发展，核磁共振尤其是功能磁共振成像（Functional magnetic resonance imaging，fMRI）能够对AD患者的大脑变性区域进行准确检测，从而利于病情确诊[3]。……