椎-基底动脉重度狭窄患者记忆力障碍与脑血流灌注相关性研究  

Correlation of memory impairment and cerebral perfusion in patients with vertebral-basilar artery stenosis

作　　者：邓一鸣[1,4] 朱梅芳 高峰[1,4] 孙瑄 刘恋[3,4] 周淑杰 顾卫彬[3] 隋滨滨 沈宓[3] 王春雪 缪中荣[1,4] Deng Yiming;Zhu Meifang;Gao Feng;Sun Xuan;Liu Lian;Zhou Shujie;Gu Weibin;Sui Binbin;Shen Mi;Wang Chunxue;Miao Zhongrong(Department of Neurology ,Belting Tiantan Hospital, Capital Medical University ,Beijing 100050, China;Department of Neuropsychiatry and Clinical Psychology ,Belting Tiantan Hospital, Capital Medical University,Belting 100050,China;Department of Rndiology,Beijing Tiantan Hospital, Caphal Medical University,Belting 100050, China;China National Clinical Research Center for Neurological Diseases ,Beijing 100050, China;China National Clinical Research Center for Neurological Diseases, Beijing 100050,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心,北京100050 [2]首都医科大学附属北京天坛医院神经精神医学与临床心理科,北京100050 [3]首都医科大学附属北京天坛医院放射科,北京100050 [4]国家神经系统疾病临床研究中心,北京100050

出　　处：《中华行为医学与脑科学杂志》2018年第4期322-326,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金项目（81371290）;北京市科技计划项目（Z161100001116112）

摘　　要：目的通过后循环CT灌注成像（CT perfusion，CTP）技术评价脑血流灌注与椎．基底动脉（vertebra—basilarartery，VBA）重度狭窄患者临床记忆力损伤的关系。方法选取2016年9月至2017年3月首都医科大学附属北京天坛医院经全脑血管造影（digital subtraction angiography，DSA）诊断为椎动脉或（和）基底动脉重度狭窄的患者（62例）。对所有患者行简易智能量表（MMSE）、临床记忆量表（甲套）量表测评及CTP检查。全部患者经临床记忆量表（甲套）评分后分为两组：无记忆力障碍组24例（其中优秀1例、高于平常6例、平常14例），记忆力障碍组38例（其中低于平常18例、边界12例、记忆力障碍8例）。应用CTP分别对测量病变区和前循环健侧相应区的达峰时间（rTTP）、平均通过时间（rMTT）、脑血流量（rCBF）、脑血容量（rCBV）等血流动力学参数值，进行定性及定量分析。结果记忆力障碍组患者CTP颞叶内侧失代偿期的发生率更高（P〈0．05）；两组在双侧颞叶内侧区域的胛P均值（1．131±0．037，1．437±0．139，t=10．520，P〈0．05）、rMTT均值（1．081±0．059，1．281±0．174，t=5．423，P〈0．05）差异具有统计学意义。结论VBA重度狭窄患者由于脑血流灌注降低更容易导致记忆力下降。Objective To evaluate the correlation between cerebral blood flow perfusion and memory impairment in patients with severe stenosis of vertebral basilar artery （ VBA）.Methods 62 cases of patients with VBA stenosis diagnosed by digital subtraction angiography（DSA） in Beijing Tiantan Hospital from September 2016 to March 2017 were enrolled. Mental State Examination （ MMSE ） , Clinical Memory Scale （CMS） test and CT perfusiou（CTP） was performed.All patients were divided into memory normal group（ n= 24, including 1 excellent case, 6 above normal cases, and 14 normal cases） and memory impairment group（ n = 38,including 18 below normal cases, 12 periphery cases, 8 impaired cases） according to CMS.The ratios of side-to-side period were compared between bilateral mesial temporal lobe and anterior circulation area.The relative time to peak （rTTP）, relative mean transit time （rMTT）, relative cerebral blood flow（rCBF） and relative cerebral blood volume （rCBV） were calculate.Results The incidence of CTP decompensation in the medial temporal lobe was higher than that in the patients with memory impairment（P〈0.05）. The difference of rTIP and rMTF value between the two groups in the bilateral medial temporal lobes was statistically significant（rTTP ： （ 1. 131 ±0.037）, （ 1.437±0.139）, t= 10.520, P〈 0.05） ; rMTT： （ 1.081 ±0.059）, （ 1.281 ± 0.174） ,t=5.423,P〈0.05）.Conclusion The patients with VBA severe stenosis are more likely to get memory impairment due to cerebral hypoperfusion.

关 键 词：椎-基底动脉狭窄 CT灌注成像 记忆力障碍 

分 类 号：R743[医药卫生—神经病学与精神病学]