摘要阿尔茨海默病诊断无中国标准,采用国际标准因语言环境等因素影响,我国痴呆诊断率低且漏诊率高.本研究小组利用神经心理学、神经影像学、分子生物学、临床神经病学等知识和技术,对阿尔茨海默病诊断涉及的记忆、语言、视空间、执行、行为和功能以及磁共振成像内侧颞叶视觉评分等检测技术及其最佳阈值和诊断价值进行了系统研究,并通过小组专家共识方式,建立了适用于中国人群的阿尔茨海默病筛查和诊断框架,改善了我国阿尔茨海默病的诊断率和准确度.其中,一个临床病理学模式的操作标准性能达到了同类技术的领先水平,使诊断敏感度提高15％,筛查记忆损害的敏感度和特异度分别提高18.1％和11.6％,检出内侧颞叶萎缩的敏感度提高24.5％,漏诊率下降34.5％;一个临床生物学模式的操作标准将诊断标准下的最新分子影像学和分子生物学诊断参数整合到框架中,推动我国阿尔茨海默病早期诊断技术迈向国际先进水平.该框架是原则性的诊断标准与操作性的诊断参数相结合的产物,适用于我国临床环境,对阿尔茨海默病早发现、早诊断、早治疗具有重要意义.

abstractsCriteria for diagnosis of Alzheimer's disease (AD) is not available in China.The international criteria is not a proper choice due to issues such as translation and lead to low diagnostic rate and high rate of missed diagnosis.The research group of Alzheimer's Disease Chinese (ADC) reviewed knowledge and techniques in neuropsychology,neuroimaging,molecular biology,and clinical neurology,and systematically studied the detection techniques such as memory,language,visuospatial,executive function,and medial temporal lobe visual scores on MRI,and their optimal threshold and diagnostic value for the diagnosis of AD.Through a systematic review and consensus meeting,a diagnostic framework for screeningAD in the Chinese population was established.Among these methods,an operational standard for clinical pathology models increased the diagnostic sensitivity by 15％.The sensitivity and specificity of screening memory impairment increased by 18.1％ and 11.6％,respectively.The sensitivity of screening medialtemporal lobe atrophy increased by 24.5％ and missed diagnosis was decreased by 34.5％.An operational standard for clinical biology models,incorporating the latest molecular imaging and molecular biology techniques,has enabled the early diagnosis of AD in China.The framework combines a principled diagnostic guideline with an operational screening protocol,which is applicable to all clinical settings and of great significance for the early detection,early diagnosis and early treatment of AD.