摘要
在老年群体之中,若老年人在早期出现认知功能障碍,则极有可能是血管性痴呆或阿尔茨海默病(AD)。若老年人因认知功能出现减退诊断为AD,也需要检查其血管老化的程度,给予患者相应的保护措施,这样可以延缓疾病发展为混合型痴呆。在临床上,腔隙性脑梗死(LI)还存有诸多疑问,国内外专家都在应用最先进的影像技术对脑微梗死展开病理学检查和分析。AD、血管性痴呆两种疾病的临床诊断和病理诊断之间会存有很大的差异,在导致老年人认知功能障碍发生原因的分析中,AD和小血管病性混合型痴呆因素均占40%,单纯血管性痴呆占10%,大血管病伴随血管性痴呆占8%,其他因素致使的痴呆仅占2%。>60%的患者往往会有病理诊断和临床诊断的偏差,从诸多的数据也反映出了神经内科医师在痴呆方面展开的试验和研究并不充分,临床需要继续加强研究,在患者起病的早期需给予其更多的生物标记物以及时确诊,及时干预,以避免疾病的进一步发展。本文从LI、脑微梗死及与认知障碍间关系的研究进展进行综述,以期为今后的相关治疗提供帮助。
In the elderly population,if the elderly have cognitive impairment in the early stage,it is very likely to be vascular dementia or Alzheimer's disease(AD).If the elderly is diagnosed as AD due to cognitive impairment,it is also necessary to check the degree of vascular aging and give corresponding protective measures to the patients,which can delay the development of the disease into mixed dementia.In clinical practice,there are stll many questions about lacunar infarction(LI),and experts at home and abroad are applying the most advanced imaging technology to carry out pathological examination and analysis of cerebral micro-infarction.There are great differences between the clinical diagnosis and pathological diagnosis of AD and vascular dementia.In the analysis of the causes of cognitive dysfunction in the elderly,the factors of AD and small vascular disease mixed dementia both accounted for 40%,simple vascular dementia accounted for 10%,large vascular disease with vascular dementia accounted for 8%,and dementia caused by other factors accounted for only 2%.More than 60%of patients often have deviations in pathological diagnosis and clinical diagnosis.Many datum also reflect that the experiment and research carried out by neurologists in dementia is not sufficient,and clinical research needs to continue to be strengthened.At the early stage of the disease,patients need to be given more biomarkers for timely diagnosis and timely intervention to avoid further development of the disease.This article reviews the research progress in the relationship between LI,cerebral micro-infarction,and cognitive impairment,with a view to providing assistance for future treatment.
作者
祖洪艳
ZU Hong-yan(Department of Neurology,Tianjin Jizhou District People's Hospital,Tianjin 301900,China)
出处
《中国城乡企业卫生》
2023年第4期24-27,共4页
Chinese Journal of Urban and Rural Enterprise Hygiene
关键词
腔隙性脑梗死
认知功能障碍
阿尔茨海默病
脑微梗死
痴呆
Lacunar infarction
Cognitive dysfunction
Alzheimer's disease
Brain micro-infarction
Dementia
作者简介
通信作者:祖洪艳,本科,主治医师,主要从事神经内科临床工作,E-mail:wwwzhy2022@126.com。
