【提要】针对我国认知筛查标准化体系缺乏和脑血管病影像学特征认定存在争议等问题，该研究小组利用神经心理学、神经影像学和临床神经病学等知识和技术，对血管性 痴呆诊断涉及的记忆、语言、视空间、执行、功能和MRI脑血管病证据等检测技术及其最佳阈值和诊断价值进行了系统研究，并通过系统综述和共识会议等形式，将原则性的诊断指南与操作性的筛查方案相结合，构建了适用于中国人群的血管性痴呆筛查和诊断框架。该框架以病史和临床评估的客观证据为核心特征，以与临床一致的脑血管病影像学证据为支持特征，并排除痴呆的其他 病因或伴随病变，适用于我国临床环境，对血管性痴呆的早发现、早诊断、早治疗具有重要意义。

【关键词】痴呆，血管性； 筛查和诊断； 框架

基金项目：中国工程院咨询研究项目（2017-ZD-06）；教育部/国家外国专家局高等学校学科创新引智计划（B08006）；教育部长江学者和创新团队发展计划（阿尔茨海默病）（IRT0810）

DOI:10.3760/cma.j.issn.0578-1426.2019.01.003

Screening and diagnostic framework of vascular dementia in Chinese population

【Summary】For lack of cognitive screening standard system and controversy over the value of imaging for cerebrovascular diseases in China, the research group of Alzheimer′s Disease Chinese ( ADC) studied the knowledge of neuropsychology, neuroimaging and clinical neurology, systematically reviewed the diagnostic techniques such as memory, language, visuospatial, executive, function, and magnetic resonance imaging (MRI) of cerebrovascular diseases, and their optimal threshold and diagnostic value for vascular dementia. Via a consensus meeting, the diagnostic guidelines and practical screening process are combined to construct a framework in Chinese population, which is based on the objective evidence of medical history and clinical evaluation. The diagnosis of vascular dementia is supported by imaging evidence of cerebrovascular diseases and differentiates from other causes of dementia or comorbidities. This consensus is applicable to medical units in China, and is of great significance for early detection, early diagnosis and early treatment of vascular dementia.

【Key words】Dementia, vascular; Screening and diagnostic; Framework

Fund programs: China Academy of Engineering′s Consulting Research Project (2017-ZD-06); Ministry of Education/National Foreign Experts Bureau′s Higher Education Discipline Innovation Initiative (B08006); Minister of Education′s Cheung Kung Scholar and Innovation Team Development Programme (Alzheimer′s Disease) (IRT0810)

DOI:10.3760/cma.j.issn.0578-1426.2019.01.003