如何诊断阿尔兹海默病 徐俊 首都医科大学附属北京天坛医院

如何诊断阿尔兹海默病 徐俊 首都医科大学附属北京天坛医院
阿尔兹海默病作为最常见的老年神经系统退变性疾病，它的诊断经历了一百多年的探索和提升的过程，最早期就是大家根据他的日常生活能力受损，记忆力显著下降以及生活自理能力，出现明显的受损才能做出来痴呆的判断，同时没有脑梗死没有脑出血没有脑肿瘤等，把可能的原因都排除掉以后，临床考虑阿尔兹海默病，最后要做大脑的病理解剖找到β淀粉样蛋白和TAU，临床化的TAU，神经元纤维缠结才能确诊，到了1980年以后制定了各种各样的认知心理量表以后，可以早期的识别这些人群，但是还是不能脱离病理学确诊的这个范畴，到了90年代末期和2000年相关的致病基因发现以后，还有最先进的Aβ淀粉样蛋白的，派特成像技术和现在正在研发和验证的TAU的派特技术，能够让我们实现更早期的深层诊断基因突变，个体在30岁左右在国外已经开始了诊断和管理的长期过程，而在散发性个体治疗过程当中，我们也可以通过症状的评估量表的测评、影像学、脑脊液等组合实现，阿尔兹海默病的准确诊断。

How to diagnose Alzheimer's disease
Alzheimer's disease is the most common neurodegenerative disease in the elderly, Its diagnosis has gone through more than 100 years of exploration and upgrading, At the earliest stage, according to his ability of daily living, Memory and self-care ability, The judgment of dementia can only be made when there is obvious damage, At the same time, there is no cerebral infarction, no cerebral hemorrhage, no brain tumor, etc, When all possible causes are eliminated, Alzheimer's disease is considered clinically, Finally, we need to do pathological anatomy of the brain to find β - amyloid protein and tau, Clinical tau, The diagnosis can only be made by tangled nerve fibers, After the development of various cognitive psychological scales after 1980, We can identify these people early, But it can't be separated from the category of pathological diagnosis, By the end of the 1990s and after the discovery of the disease causing genes in 2000, And the most advanced a β amyloid, Pater imaging technology and the pater technology of tau that is currently under development and verification, It can enable us to achieve a deeper diagnosis of gene mutations at an earlier stage, At the age of 30 or so, individuals have begun a long-term process of diagnosis and management in foreign countries, In the process of sporadic individual therapy, We can also use the combination of symptom assessment scale, imaging, cerebrospinal fluid, etc, Accurate diagnosis of Alzheimer's disease.