老年高血压病患者认知功能障碍程度与磁共振弥散加权成像表观弥散系数的关系  

The Relationship between the Cognitive Impairment of the Elderly Hypertensive with the ADC Values of the MR-DWI

作　　者：赵言玮[1] 曲毅[2] 赵洁慧[2] 方宁远[3] 胡祖鹏[1] 

机构地区：[1]复旦大学附属华山医院急诊科,200040 [2]上海市徐汇区中心医院老年病科,200031 [3]上海交通大学医学院附属仁济医院老年病科,200127

出　　处：《中国临床神经科学》2011年第3期285-290,301,共7页Chinese Journal of Clinical Neurosciences

摘　　要：目的：研究老年高血压病患者认知功能障碍程度与头颅各部位磁共振弥散加权成像（MR-DWI）的表观弥散系数（ADC）值的关系,探讨轻度认知功能障碍（MCI）早期诊断和评估的参考指标。方法：入选60~80岁的老年高血压病患者40例进行现状调查。运用蒙特利尔认知量表（MoCA）和临床痴呆评定量表（CDR）对入选患者进行认知功能评定并分组：认知功能正常组8例、轻度认知功能障碍（MCI）组22例和痴呆组（VaD）10例。行MR-DWI检查,测算头颅各解剖部位ADC值。采用SPSS16.0软件进行数据统计分析。结果：①认知功能正常组和MCI组与VaD组比较,MoCA和CDR评分差异均有显著统计学意义（P〈0.01）。②认知功能正常组和MCI组与VaD组比较,舒张压差异有统计学意义（P〈0.01）,收缩压差异无统计学意义（P〉0.05）。③认知功能正常组和MCI组与VaD组比较,左侧半卵圆中心、右侧海马和左侧内囊ADC值差异有统计学意义（P〈0.05）。④认知功能正常组与MCI组比较,右侧海马ADC值差异有统计学意义（P〈0.0167）;MCI组与VaD组比较,左侧内囊差异有统计学意义（P〈0.0167）。结论：老年高血压病患者收缩压水平与认知功能相关。左侧半卵圆中心、右侧海马、左侧内囊区功能结构变化与认知功能密切相关。早期右侧海马区改变显著,后期左侧内囊区改变明显。Aim： This study was designed to observe the relationship of the apparent diffusion coefficient （ADC） value in the old hypertensive with mild cognitive impairment （MCI）. To investigate the reference index of the early diagnosis and assessment for MCI. Methods： A total of 40 patients were categorized in three groups：8 normal cognitive function group,22 MCI group and 10 vascular dementia group,through using Montreal Cognitive Assessment （MoCA） and Clinical Dementia Rating Assessment （CDR） to determine cognitive change. Then, the ADC values in the different brain anatomic sites of the selected patients were calculated. SPSS16.0 was used to perform the statistic analysis. Results： ① In the three groups, the MoCA scores and the CDR scores had observable difference（P0.01）. ②Compared with the normal cognitive function group, the diastolic blood pressure increased significantly in the MCI group and the vascular dementia group （P0.01）. But systolic blood pressure had no observable difference （P0.05）. ③Compared with the normal cognitive function group and vascular dementia group, the ADC values of the left centrum ovale, the right hippocampus and the left endocorpus had significant differences in the MCI group （P0.05）. ④Compared with the normal cognitive function group and the MCI group, the ADC values of the right hippocampus had significant differences （P0.016 7）. Compared with the MCI group and the vascular dementia group, the left endocorpus had significant differences （P0.016 7）. Conclusion： In elderly hypertensive patients, DBP was closely related to cognitive function, as well as the functional and structural changes in the left centrum ovale, the right hippocampus and the left endocorpus. And in the early time, the change in the right hippocampus was significant, but in the later time, the change in the left endocorpus was great.

关 键 词：轻度认知功能障碍 蒙特利尔认知量表 临床痴呆评定量表 磁共振弥散加权成像 表观弥散系数 

分 类 号：R544.1[医药卫生—心血管疾病] R749.1[医药卫生—内科学]