痴呆病因的种族差异及大脑中阿尔茨海默病变的发生率
Racial differences in the etiology of dementia and frequency of Alzheimer lesions in the brain.
作者信息
de la Monte S M, Hutchins G M, Moore G W
出版信息
J Natl Med Assoc. 1989 Jun;81(6):644-52.
Empirical observations suggest a preponderance of cases of sporadic Alzheimer's disease among whites relative to blacks. If true, this might indicate a genetic basis for non-familial Alzheimer's disease. Among 6,000 consecutive autopsies performed at The Johns Hopkins Hospital, 242 adults with dementia were identified. The 98 consultation cases were excluded from the data analysis because of potential selection bias. Among the remaining 144 cases, the proportions of whites and blacks were similar, yet the frequency of Alzheimer's disease was 2.6 times higher among whites (P = 0.001), dementia due to Parkinson's disease was more frequent among whites (P = 0.05), and the frequencies of multi-infarct dementia and dementia due to chronic ethanol abuse were higher among blacks (P = 0.004 and P = 0.007, respectively). Moreover, in brains from neurologically intact controls, incidental histologic lesions of Alzheimer's disease were observed more frequently in whites than blacks (P = 0.01). These findings provide a strong argument in favor of genetic transmission of sporadic Alzheimer's disease.
经验观察表明，散发性阿尔茨海默病的病例在白人中比黑人更为多见。如果这是真的，那么这可能表明非家族性阿尔茨海默病存在遗传基础。在约翰霍普金斯医院连续进行的6000例尸检中，确定了242例患有痴呆症的成年人。由于存在潜在的选择偏倚，98例会诊病例被排除在数据分析之外。在其余144例病例中，白人和黑人的比例相似，但白人中阿尔茨海默病的发病率高出2.6倍（P = 0.001），帕金森病所致痴呆在白人中更为常见（P = 0.05），而多发性梗死性痴呆和慢性乙醇滥用所致痴呆在黑人中更为常见（分别为P = 0.004和P = 0.007）。此外，在神经功能正常的对照者大脑中，阿尔茨海默病的偶然组织学病变在白人中比黑人中更常见（P = 0.01）。这些发现为散发性阿尔茨海默病的遗传传递提供了有力证据。
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