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阿尔茨海默病(Alzheimer's disease,AD)是最普遍的神经认知功能紊乱疾病,是一种以记忆和认知功能(如定向、计算、语言、推理、判断、概括和执行等)障碍为主要表现的疾病,可以导致记忆丧失、语言系统损害、计算能力及实践能力下降等,它可以极大程度地降低患者的自主行为能力。AD典型的病理特征表现为由磷酸化tau蛋白组成的神经元内的神经纤维缠结和β-淀粉样蛋白(amyloid β-protein,Aβ)沉积形成的神经元外老年斑。目前AD病因不明,但淀粉样蛋白级联假说被广泛认可[1]。假说认为过度聚集的Aβ启动了一系列的病理生理过程,最终导致神经元的死亡、白质的异常聚集、胶质细胞活化、多条神经递质通路功能下降,从而导致认知和行为能力的下降,临床上表现为痴呆。近年来,AD的诊断标准不断修改,新的生物标志物扮演着重要的角色。最新的国际工作组-2标准中建议将脑脊液中的生物学标志物(Aβ42、Tau、p-Tau)和Aβ PET作为诊断AD的病理学基础[2]。目前PET显像不仅可以帮助诊断、鉴别AD并预测其进展,而且对临床实验中的AD治疗也有很大帮助。近年来,很多新的放射性示踪剂被允许在人体内使用。目前AD PET显像的主要方法有:葡萄糖代谢显像、淀粉样蛋白显像、Tau蛋白显像、炎症显像及胆碱能显像。
PET在阿尔茨海默病中的应用和进展
Applications and advances of PET imaging in Alzheimer's disease
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摘要: 阿尔茨海默病(AD)是老年痴呆的主要类型,约占痴呆病例的60%~80%。随着我国人口平均寿命的延长和老年人口数量的增加,AD的发病率不断提高,给社会及家庭带来巨大的经济负担,引起了国内外学者的高度重视。PET是一种先进的临床影像检查技术,在AD的诊断和研究中具有更高的灵敏度和准确率。笔者就近年来PET在AD中的应用和进展进行综述。
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关键词:
- 阿尔茨海默病 /
- 正电子发射断层显像术
Abstract: Alzheimer's disease (AD) is the main type of senile dementia and accounts for about 60% to 80% of dementia cases. With the prolongation of the average life expectancy of our country's population and the increase of the elderly population, the continuous increase of the incidence rate of AD brings a huge economic burden to the society and the family, which has attracted the attention of scholars at home and abroad. PET is an advanced clinical imaging examination technique that can provide a higher sensitivity and accuracy for the diagnosis of AD. In this paper, the application progress of PET imaging in Alzheimer's disease was reviewed.-
Key words:
- Alzheimer disease /
- Positron-emission tomography
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