认知障碍患者颅内动脉狭窄与脑白质胆碱能通路病变的关系  

Association between intracranial arterial stenosis and cholinergic pathway lesions in the white matter in patients with cognitive impairment

作　　者：蒋艳艳 袁由军 李顺均 聂志余[2] 李云霞[2] JIANG Yan-Yan;YUAN You-Jun;LI Shun-Jun;NIE Zhi-Yu;LI Yun-Xia(Department of Neurology,Wenzhou Central Hospital,Wenzhou,ZheJiang 325000,China)

机构地区：[1]温州市中心医院神经内科,浙江省温州市325000 [2]同济大学附属同济医院神经内科,上海市200065

出　　处：《国际神经病学神经外科学杂志》2018年第4期355-359,共5页Journal of International Neurology and Neurosurgery

基　　金：国家自然科学基金(81671307);浙江省温州市科技计划项目(Y20170074)

摘　　要：目的探讨认知功能障碍患者中颅内动脉狭窄与脑白质胆碱能通路病变的相关性。方法连续收集符合入组标准的病例118例。对入组患者行蒙特利尔认知量表(Mo CA)评估认知功能、头颅CT血管成像采集颅内血管信息、头颅磁共振采集脑白质病变情况,按认知功能水平,分为认知功能障碍组(研究组,85例)和认知功能正常组(对照组,33例)。结果相较于对照组,研究组颅内血管狭窄比例较高,差异有统计学意义(P=0.042)。研究组Mo CA总分及其分项均低于对照组,差异有统计学意义(P<0.01);研究组CHIPS得分高于对照组,差异有统计学意义(P=0.047)。CHIPS得分与Mo CA评分及其部分分项呈负相关(均P<0.05)。颅内动脉狭窄与Mo CA评分及其分项(除抽象功能)呈负相关(均P<0.05);CHIPS得分与颅内动脉狭窄呈正相关(P=0.001)。结论颅内动脉狭窄在脑白质胆碱能通路病变致使多领域认知功能障碍过程中起到一定作用。Objective To investigate the association between intracranial artery stenosis and cholinergic pathway lesions in the white matter in patients with cognitive impairment. Methods A total of 118 patients who met the inclusion criteria were enrolled. Montreal Cognitive Assessment （MoCA） was used to evaluate cognitive function, cranial CT angiography was used to collect the information of intracranial vessels, and cranial magnetic resonance imaging was used to evaluate the lesions in white matter. According to cognitive function, the patients were divided into cognitive impairment group （ study group with 85 patients） and normal cognition function group （control group with 33 patients）. Results The study group had a significantly higher proportion of patients with intracranial vascular stenosis than the control group （ P = 0. 042 ）. Compared with the control group, the study group had significantly lower total MoCA score and the scores of each subitem （P 〈0.01 ） and a significantly higher CHIPS score （P = 0. 047 ）. The CHIPS score was negatively correlated with total MoCA score and the scores of some sub-items （ all P 〈 0.05 ）. Intracranial arterial stenosis was negatively correlated with MoCA score and the scores of all subitems except abstract function （ all P〈0.05 ）, and the CHIPS score was positively correlated with intracranial arterial stenosis （P=0.001）. Conclusions Intracranial arterial stenosis plays a role in the process of cognitive impairment caused by cholinergic pathway lesions in the white matter.

关 键 词：认知功能障碍 颅内动脉狭窄 胆碱能纤维 脑白质病变 

分 类 号：R749.1[医药卫生—神经病学与精神病学]