非痴呆型血管性认知功能障碍患者脑血流与MMSE及MoCA评分的相关性研究  

A Correlation Study between the Changes of Cerebral Blood Flow and MMSE and MoCA Scores in Vascular Cognitive Impairment with No Dementia

作　　者：王前友 王文安[1,2] 沈亚雯[1] 潘溢丹[1] 赵燕燕[1] 谢娟[1] 施德[1] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院神经内科,202150 [2]上海交通大学医学院附属新华医院神经内科,200093

出　　处：《中国临床神经科学》2014年第4期369-376,共8页Chinese Journal of Clinical Neurosciences

基　　金：院重点扶持学科资助项目(编号:2011-YFC-07)

摘　　要：目的 应用单光子发射计算机断层扫描（SPECT）成像术研究非痴呆型血管性认知障碍（VCIND）患者的局部脑血流（rCBF）改变,并分析其与神经心理评分的关系。方法 纳入1VCIND患者45例（VCIND组）,其中男25例、女20例;2认知功能正常脑卒中（SNC）患者28例（SNC组）,其中男16例、女12例;3健康对照者15例（HC组）,其中男6例、女9例。所有研究对象行一般检查、神经心理评定（MMSE量表、MoCA量表、CDR量表、NIHSS量表、ADL量表、Loeb量表、Hamilton抑郁量表）及SPECT rCBF检查。结果 1与HC组比较,VCIND组两侧额叶、两侧顶叶上部、左侧丘脑rCBF明显降低（P〈0.05）,SNC组左侧额叶、左侧顶叶下部、左侧颞叶、两侧丘脑以及两侧纹状体rCBF明显降低（P〈0.05）;2与SNC组比较,VCIND组左侧额叶、左侧顶叶上部以及左侧丘脑rCBF明显降低（P〈0.05）;3VCIND组内,左侧额叶、左侧顶叶上部、左侧丘脑均较右侧相应部位rCBF明显降低（P〈0.05）;4相关分析显示VCIND组MMSE评分与左侧额叶、左顶叶上部、两侧颞叶内侧、左侧纹状体rCBF呈正相关（r=0.73~0.84,P〈0.05）,MoCA评分与左侧额叶、右侧顶叶下部、两侧颞叶内侧rCBF呈正相关（r=0.65~0.85,P〈0.05）。结论 SPECT探查VCIND患者rCBF改变具有重要临床意义,MMSE及MoCA评分与局部rCBF改变具有一定相关性。Aim To investigate the regional cerebral blood flow （rCBF） changes in vascular cognitive impairment with no dementia （VC1ND） patients with single-photon emission computed tomography （SPECT） and to analyze its relationship with neuropsychological score. Methods 45 cases of VCIND group （male25, female 20） were recruited and 28 cases of stroke with normal cognition （SNC） group （male 16, female 12） were recruited, and 15 cases of healthy control （HC） group （male 6, female 9） were recruited. All subjectsunderwent a general examination, neuropsychological test, brain SPECT perfusion imaging. Results Compared with the HC group, the rCBF in the bilateral frontal lobe, bilateral superior parietal lobe and left thalamus in the VC1ND group were significantly reduced （P〈0.05）. The rCBF of the left frontal lobe, left inferior parietal lobe, left temporal lobe and bilateral thalamus and striatum were significantly reduced in SNC group （P〈0.05）. The rCBF of the left frontal lobe, left superior parietal lobe and left thalamus were significantly lower in VCIND group than SNC group （P〈0.05）. Within the VC1ND group the rCBF of the left frontal, left superior parietal lobe, and left thalamus were significantly reduced compared with the right corresponding regions （P〈0.05）. Correlation analysis in VCIND group showed that, Mini Mental State Examination （MMSE） score was positively correlated with the rCBF of the left frontal lobe, left superior parietal lobe, bilateral medial temporal lobe, and left striatum （r=0.73-0.84, P〈0.05）. Montreal Cognitive Assessment （MoCA） score was positively correlated with the rCBF of left frontal lobe, right inferior parietal lobe, bilateral medial temporal lobe （r=0.65-0.85, P〈0.05）. Conclusion SPECT is of great significance in detecting early rCBF changes in VCIND cases. MMSE and MoCA score have certain degree of correlation with rCBF changes.

关 键 词：认知功能 单光子发射计算机断层扫描 神经心理评分 非痴呆型血管性认知功能障碍 

分 类 号：R743[医药卫生—神经病学与精神病学]