Comparison of pathological diagnostic criteria for Alzheimer disease
Comparison of pathological diagnostic criteria for Alzheimer disease
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DOI：
10.1097/00002093-199809000-00010
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发表时间：
1998-09-01
影响因子：
2.1
通讯作者：
Smith, AD
中科院分区：
文献类型：
--
作者：
Nagy, Z;Esiri, MM;Smith, AD
由于阿尔茨海默病（AD）的临床表现往往难以与其他痴呆性疾病区分开来，AD的诊断需要神经病理学证实。然而，对于AD的病理诊断，目前还没有一致接受的标准。目前使用的三组病理学标准（Khachaturian：Khachaturian，Arch Neural 1985;42：1097-105; Tierny：Tierney等人，Can J Neurol Sci 1986;13：424-6; CERAD：Mirra等人，Neurology 1991;41：479-86）对于该疾病的治疗彼此相当不同。我们将这些标准应用于前43名连续受试者（37名痴呆），这些受试者在牛津研究记忆和衰老项目（OPTIMA）的纵向前瞻性临床研究后，除了尸检的AD型病理外，没有神经病理学。结果表明，CERAD类别的明确AD密切对应的情况下，满足Tierney A3纳入标准的AD。CERAD的可能、很可能和明确AD的组合类别与满足Khachaturian AD标准的病例密切对应。当应用Khachaturian和CERAD标准时，痴呆的临床诊断的影响是相当大的，因为根据临床痴呆是否存在或不存在，93%至90.7%的患者将被不同地分类。
Because the clinical picture of Alzheimer disease (AD) is often difficult to discriminate from other dementing illnesses, the diagnosis of AD requires neuropathological confirmation. However, for the pathological diagnosis of AD, there are no unanimously accepted criteria. The three currently used sets of pathological criteria (Khachaturian: Khachaturian, Arch Neural 1985;42:1097-105; Tierny: Tierney et al., Can J Neurol Sci 1986;13:424-6; CERAD: Mirra et al., Neurology 1991;41:479-86) for the disease differ from each other considerably. We applied these criteria to the first 43 consecutive subjects (37 demented) with no neuropathology other than AD-type pathology from autopsies after longitudinal prospective clinical study in the Oxford Project to Investigate Memory and Ageing (OPTIMA). The results show that the CERAD category of definite AD corresponds closely with the cases that fulfill Tierney A3 inclusion criteria for AD. The combined CERAD categories of possible, probable, and definite AD correspond closely to cases fulfilling Khachaturian criteria for AD. The influence of a clinical diagnosis of dementia when Khachaturian and CERAD criteria were applied was considerable because between 93% and 90.7% of patients would have been categorized differently depending on whether clinical dementia was present or absent.