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阿尔茨海默病的诊断与治疗。

Diagnostics and therapy of Alzheimer's disease.

作者信息

Mikiciuk-Olasik Elzbieta, Szymański Paweł, Zurek Elzbieta

机构信息

Department of Pharmaceutical Chemistry and Drug Analyses, Medical University, Muszyńskiego 1, 90-151 Lódź, Poland.

出版信息

Indian J Exp Biol. 2007 Apr;45(4):315-25.

Abstract

Alzheimer's Disease (AD) is described as a degenerative disease of the central nervous system characterized by a noticeable cognitive decline defined by a loss of memory and learning ability, together with a reduced ability to perform basic activities of daily living. In the brain of an AD patients is the dramatic decrease in cholinergic innervation in the cortex and hippocampus due to the loss of neurons in the basal forebrain. The above findings led to the development of the cholinergic hypothesis, which proposes that the cognitive loss associated with AD is related to decreased cortical cholinergic neurotransmission. In brain of Alzheimer's patient's one ascertained presence of neuritic plaques containing the beta-amyloid peptide and protein tau. Biochemical and genetics studies implicated a central role for beta-amyloid in the pathological cascade of events in AD. The most therapeutic strategies in AD have been directed to two main targets: the beta-amyloid peptide and the cholinergic neurotransmission. The first approach is to act on the amyloid precursor protein (APP) processing. The second main approach is to slow of decline of neuronal degeneration or increasing cholinergic transmission. Diagnosis of AD is very difficult and to date no specific diagnostic tests of the disease are available. Intellectual function testing to determine the degree of cognitive status during routine medical examination is a useful supplementary method of diagnosing dementia. The permissible result, come down from radiopharmacy, which is an integral part of a nuclear medicine. A radiopharmaceutical may be defined as a pharmaceutical substance containing radioactive atoms. Positron emission tomography (PET) and single photon emission computed tomography (SPECT) are capable of mapping the distribution of radionuclides in three dimensions, producing maps of brain biochemical and physiological processes. The techniques are reasonably sensitive and specific in differentiating AD from other dementias.

摘要

阿尔茨海默病(AD)被描述为一种中枢神经系统退行性疾病,其特征是明显的认知衰退,表现为记忆和学习能力丧失,以及日常生活基本活动能力下降。在AD患者的大脑中,由于基底前脑神经元的丧失,皮质和海马中的胆碱能神经支配显著减少。上述发现导致了胆碱能假说的发展,该假说提出与AD相关的认知丧失与皮质胆碱能神经传递减少有关。在阿尔茨海默病患者的大脑中,可以确定存在含有β-淀粉样肽和tau蛋白的神经炎性斑块。生化和遗传学研究表明β-淀粉样蛋白在AD病理事件级联反应中起核心作用。AD的大多数治疗策略都针对两个主要靶点:β-淀粉样肽和胆碱能神经传递。第一种方法是作用于淀粉样前体蛋白(APP)的加工过程。第二种主要方法是减缓神经元变性的衰退或增强胆碱能传递。AD的诊断非常困难,迄今为止尚无针对该疾病的特异性诊断测试。在常规医学检查中进行智力功能测试以确定认知状态的程度是诊断痴呆症的一种有用的辅助方法。放射性药物检查结果是可行的,放射性药物是核医学的一个组成部分。放射性药物可以定义为含有放射性原子的药物物质。正电子发射断层扫描(PET)和单光子发射计算机断层扫描(SPECT)能够在三维空间中绘制放射性核素的分布,生成脑生化和生理过程的图谱。这些技术在区分AD与其他痴呆症方面具有相当的敏感性和特异性。

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