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[巴西阿尔茨海默病的诊断:诊断标准与辅助检查。巴西神经病学学会认知神经病学与衰老科学部的建议]

[Diagnosis of Alzheimer's disease in Brazil: diagnostic criteria and auxiliary tests. Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology].

作者信息

Nitrini Ricardo, Caramelli Paulo, Bottino Cássio Machado de Campos, Damasceno Benito Pereira, Brucki Sonia Maria Dozzi, Anghinah Renato

机构信息

Departamento Científico de Neurologia Cognitiva e do Envelhecimento, Academia Brasileira de Neurologia, Brazil.

出版信息

Arq Neuropsiquiatr. 2005 Sep;63(3A):713-9. doi: 10.1590/s0004-282x2005000400033. Epub 2005 Sep 9.

Abstract

This panel had the objective of recommending evidence-based guidelines for the clinical diagnosis of Alzheimer's disease (AD) in Brazil. Guidelines from other countries and papers on the diagnosis of AD in Brazil were systematically evaluated in a thorough research of PUBMED and LILACS databases. The panel concluded that dementia diagnosis should be based on the DSM criteria and AD diagnosis, on the McKhann et al. criteria (NINCDS-ADRDA). The recommended auxiliary tests are: blood cell count, blood urea nitrogen, serum levels of creatinine, free-thyroxine, thyroid-stimulant hormone, albumin, hepatic enzymes, vitamin B12 and calcium, serological tests for syphilis and, for those aged less than 60 years, serological tests for HIV. Cerebrospinal fluid examination is recommended in special situations. Computed tomography (or preferentially magnetic resonance imaging, when available) is mandatory and has the main objective of excluding other diseases. SPECT and EEG are optional diagnostic methods.

摘要

该小组旨在为巴西阿尔茨海默病(AD)的临床诊断推荐循证指南。通过对PUBMED和LILACS数据库进行全面检索,系统评估了其他国家的指南以及巴西有关AD诊断的论文。该小组得出结论,痴呆症的诊断应基于DSM标准,而AD的诊断应基于McKhann等人的标准(NINCDS - ADRDA)。推荐的辅助检查包括:血细胞计数、血尿素氮、血清肌酐水平、游离甲状腺素、促甲状腺激素、白蛋白、肝酶、维生素B12和钙、梅毒血清学检测,对于年龄小于60岁的患者,还需进行HIV血清学检测。特殊情况下建议进行脑脊液检查。计算机断层扫描(若有条件,优先选择磁共振成像)是必需的,其主要目的是排除其他疾病。SPECT和脑电图是可供选择的诊断方法。

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