在晚期痴呆症中的脑微出血：临床和病理学的相关性。
Cerebral Microbleeds in Advanced Dementia: Clinical and Pathological Correlates.
机构信息
1 Móstoles University Hospital, Madrid, Spain.
2 Alzheimer's Center Reina Sofía Foundation-CIEN Foundation and CIBERNED, Carlos III Institute of Health, Madrid, Spain.
出版信息
Am J Alzheimers Dis Other Demen. 2018 Sep;33(6):362-372. doi: 10.1177/1533317518770783. Epub 2018 May 7.
OBJECTIVE
We conducted a longitudinal study to explore the clinical and pathological correlates of cerebral microbleeds (CMBs) in institutionalized patients with dementia.
METHODS
Clinical and magnetic resonance imaging (MRI) data were extracted from 182 nursing home patients (mean age [standard deviation]: 81.3 [6.9], 78.0% female, and 83.4% moderate to severe dementia), which were divided according to the CMBs number and location. One-year follow-up data were obtained from 153 patients, and postmortem pathological diagnosis was available in 40 patients.
RESULTS
Cerebral microbleeds were observed in 42.9% of patients and were associated with MRI ischemic lesions ( P < .0005). In the adjusted analysis, lobar CMB predicted worsening of parkinsonism (standardized β: 0.43) and gait (standardized β: 0.24). A pathological diagnosis of Alzheimer's disease was less frequent in the brains of patients with lobar and deep CMB (33.3% vs 85.3%; P < .05).
CONCLUSION
Cerebral microbleeds were linked to cerebrovascular disease and predicted motor deterioration in institutionalized people with advanced dementia.
目的
我们进行了一项纵向研究，以探讨机构化痴呆患者脑微出血（CMBs）的临床和病理学相关性。
方法
从 182 名养老院患者（平均年龄[标准差]：81.3[6.9]，78.0%为女性，83.4%为中重度痴呆）中提取临床和磁共振成像（MRI）数据，这些患者根据 CMB 数量和位置进行了分组。对 153 名患者进行了为期 1 年的随访，40 名患者进行了尸检病理诊断。
结果
42.9%的患者存在脑微出血，且与 MRI 缺血性病变相关（P<.0005）。在调整分析中，皮质下 CMB 预测帕金森病（标准化β：0.43）和步态（标准化β：0.24）恶化。皮质下和深部 CMB 患者的阿尔茨海默病病理诊断较少见（33.3% vs 85.3%；P<.05）。
结论
脑微出血与脑血管疾病有关，并预测了晚期痴呆机构化人群的运动恶化。
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