经颅多普勒屏气实验与脑卒中后认知障碍转归的关系研究  

The relationship of breathing-holding test by transcranial doppler and cognitive outcomes after stroke

作　　者：彭琼[1] 林百喜[1] 龙建庭[1] 王红卫[1] 李竟艳[1] 成明强[1] 鲁玲[1] 游咏[1] 

机构地区：[1]衡阳南华大学第一附属医院神经内科,湖南421001

出　　处：《卒中与神经疾病》2011年第5期282-285,共4页Stroke and Nervous Diseases

基　　金：湖南省卫生厅医药卫生科研计划课题(B2006-112);湖南省卫生厅科研计划课题(B2010-044);南华大学研究生创新课题(2010XCX14)

摘　　要：目的探讨缺血性脑卒中患者脑血管储备功能和脑卒中后认知障碍的转归关系。方法选取89例急性缺血性脑卒中患者,42例为单侧症状性大脑中动脉粥样硬化性狭窄(MCAS),47例为腔隙性脑梗死(LI),40例门诊健康老年人为对照组。在急性期(1～14 d)和恢复期(3个月后)分别对入组患者行经颅多普勒超声(TCD)检查,计算屏气指数(breath-holding index,BHI),并应用蒙特利尔认知评估量表(MontrealCognitive Assessment,MoCA)进行认知功能评分。结果 LI组急性期和恢复期BHI值及MoCA分值均低于对照组(P<0.05),恢复期无明显改善(P>0.05);症状性MCAS组急性期患侧BHI值显著低于对照组(P<0.01)及健侧(P<0.05),恢复期患侧BHI值改善明显(P<0.05),急性期与恢复期MoCA分值均低于同时期对照组(P<0.05),恢复期MoCA分值改善明显(P<0.05)。BHI变化值和MoCA变化值存在显著正相关(r=0.899,P=0.000)。结论缺血性脑卒中急性期脑血管储备功能和认知功能受到损害,恢复期有所改善,以症状性MCAS受损及改善明显,且脑血管储备功能改善程度与认知转归具有一定相关性。Objective To evaluate the relationship of Cerebrovascular Reserve and cognitive in patients with difrerent ischemic stroke patients. Methods We evaluated the breath-holding index（BHI） by using the breath-holding index technique during bilateral Transcranial Doppler monitoring of flow velocity in the middle cerebral arteries（MCA） of 42 patients with symptomatic middle cerebral artery atherost enosis（MCAS） and 47 patients with lacunar infarction and 40 healthy elderly outpatients in acute（1～14 d） and recovery period（after 3 months）. Results BHI and MoCA were lower in patients with LI than that in the control subjects（P0.05） in acute and recovery period,no obvious improvement in recovery period（P0.05）.BHI in MCA with infarction focus was significantly lower than with no focus（P0.05） and the control subjects（P0.01） in acute period,BHI of infarction was significantly improved（P0.05） in recovery period,MoCAin acute and recovery period were lower than the control subjects（P0.05）,improving significantly（P0.05） in recovery period.MoCA was significantly positive correlation with BHI（r=0.899,n=89,P=0.000）. Conclusions Cerebrovascular reserve function and cognitive function damage of ischemic stroke patients in acute and recovery period,with symptomatic MCAS damage and improved significantly,and the improvement of cerebrovascular reserve has some relevance with cognitive outcome.

关 键 词：经颅多普勒 缺血性脑卒中 蒙特利尔认知评估量表 脑血管储备 屏气指数 

分 类 号：R743[医药卫生—神经病学与精神病学]