轻度脑白质疏松症患者认知能力与搏动指数的相关性  

Correlation between cognitive ability and pulsatility index in patients with mild leukoaraiosis

作　　者：高春媛 刘星亮[2] 娄展 刘占矿[3] 岳秉宏[2] GAO Chunyuan;LIU Xingliang;LOU Zhan;LIU Zhankuang;YUE Binghong(Basic Medical College,Hebei North University;Department of Neurology of First Affiliated Hospital,Hebei North University;Department of Geriatrics of First Affiliated Hospital,Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院基础医学院 [2]河北北方学院附属第一医院神经内三科 [3]河北北方学院附属第一医院老年科,河北张家口075000

出　　处：《山东大学学报（医学版）》2020年第4期95-99,104,共6页Journal of Shandong University:Health Sciences

基　　金：张家口市科学技术研究与发展计划(1811032D-1)。

摘　　要：目的探究轻度脑白质疏松症(LA)患者认知能力及大脑中动脉搏动指数(PI)的相关性。方法收集2019年4~10月就诊患者,将46名轻度侧脑室旁LA且受教育程度大致相同的患者组成研究组,将同期50名无LA的志愿者组成对照组,收集临床资料,均行蒙特利尔认知量表(MoCA)评估、画钟测试及经颅多普勒超声检查,记录PI值。结果研究组MoCA评分较对照组减低(t=-3.780,P<0.001),PI值增高(t=6.875,P<0.001),且研究组MoCA分值与PI值存在显著负相关(r=-0.852,P<0.05)。研究组总体及多个认知领域分值较对照组低,其中视空间与执行、注意与计算、延迟记忆受损较对照组差异有统计学意义(P均<0.05),其与PI值呈现一定负相关(分别为r=-0.800,r=-0.386,r=-0.587,P<0.05)。画钟测试作为视空间与执行功能中一个重要组成部分,研究组评分低于对照组(t=-2.831,P<0.05),且与PI值负相关(r=-0.715,P<0.05)。结论轻度LA患者在亚临床期,可能已存在认知能力及脑血流储备功能受损,在LA的早期识别中PI与MoCA评估量表有等同应用价值。通过不同认知领域受损的比较,以画钟测试与PI相关性研究为例,提示临床上可在早期进行针对性干预。Objective To investigate the correlation between cognitive ability and pulsatility index(PI)of middle celebral artery in patients with mild leukoaraiosis(LA).Methods A total of 46 patients with mild paraventricular LA treated during Apr.and Oct.2019 who had the same education level were enrolled as study group,and another 50 volunteers without LA who had the same education level were selected as controls.The two groups were evaluated with Montreal Cognitive scale(MoCA),clock drawing test(CDT)and transcranial Doppler(TCD).The PI of each participant was recorded.Results The study group had significantly lower MoCA score(t=-3.780,P<0.001)but higher PI(t=6.875,P<0.001)than the control group.There was a negative correlation between MoCA score and PI in the LA patients(r=-0.852,P<0.05).In addition to declined overall cognitive level,the study group had lower scores of spatial and executive functions,attention and calculation,and delayed memory impairment than the control group(all P<0.05).There was a negative correlation between PI and spatial and executive functions(r=-0.800),attention and calculation(r=-0.386),and delayed memory impairment(r=-0.587).The study group had lower CDT score than the control group(t=-2.831,P<0.05),and the CDT score was negatively correlated with PI(r=-0.715,P<0.05).Conclusion Mild LA patients may have impaired cognitive function and cerebral flow reserve in the subclinical stage.In the early diagnosis of LA,PI is as important as MoCA.Comparison of impairment of different cognitive domains is helpful in the early intervention of LA,taking the correlation befween CDT and PI as an exemple.

关 键 词：脑白质疏松症 蒙特利尔认知评估量表 经颅多普勒超声 搏动指数 脑血流储备 

分 类 号：R743[医药卫生—神经病学与精神病学]