痴呆患者の予後と脳血流量，脳萎縮との関連について

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  • The relationship between prognosis, regional cerebral blood flow(rCBF) and brain atrophy in dementia.
  • チホウ カンジャ ノ ヨゴ ト ノウ ケツリュウリョウ ノウ イシュク ト ノ

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The prognosis of dementia has generally been regarded as poor, and its five year motality rate is reported to be about 80%. Recently, Barclay and Rogers have reported that the pattern of rCBF reduction is different between multiinfarct dementia (MID) and dementia of the Alzheimer type (DAT). We studied the relationship between prognosis, brain atrophy and cerebral blood flow in thirty-five demented patients (22 MID and 13 DAT) by using bi-dimensional brain atrophy indices and the 133Xe inhalation method. The mean follow-up period was 18 months. MID group showed signifcantly lower rCBF than DAT group at start point. Three patients of DAT and eight patients of MID were died. In MID, two patients died because of recurrent cerebrovascular accident, and others died because of infectious disease, renal failure, and unknown causes. In DAT, patients were died because of infectious disease, cardiac failure, and sudden death. The rCBF reduction in the bilateral parietal regions related with poor prognosis of DAT. In MID, the reduction of rCBF were more marked and diffuse pattern than that of DAT and patients who showed lower rCBF had poor prognosis. Motality rate was getting higher with advancing brain atrophy in DAT, but MID showed no such relationship. These results indicated that the quantitative evaluation of the brain atrophy and rCBF measurement may be useful not only to diagnose the type of dementia but also to suppose the prognosis of the demented patients.

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