脑小血管病患者中影像学标记物及整体负担与轻度帕金森样体征的关系  

Relation of cerebral small vessel diseases and total burden to mild Parkinsonian signs

作　　者：王莎莎[1] 魏森[1] 许予明[1] WANG Shasha;WEI Sen;XU Yuming(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan)

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2020年第9期760-765,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的轻度帕金森样体征(mild parkinsonian signs,MPS)可能与脑小血管疾病(cerebral small-vessel disease,CSVD)有关。探究CSVD患者中各影像学指标以及整体影像负担与MPS之间的关系。方法纳入2018-03—2019-08就诊于郑州大学第一附属医院的小动脉硬化性CSVD患者,并记录了血管危险因素、血液学指标等临床资料以及影像学指标。采用统一帕金森病评定量表(unified Parkinson’s disease rating scaleⅢ,UPDRSⅢ)评估MPS,调整年龄、性别、卒中病史等血管危险因素后进行多因素Logistic回归分析判断CSVD影像学指标以及整体影像负担与MPS之间的关系。结果研究共纳入98例患者中45例(48.9%)发生MPS。分别对CSVD各影像学特征、CSVD整体负担与MPS的关系进行Logistic多因素回归分析,发现腔隙(OR=3.426,P=0.012)、重度PWMH(OR=2.946,P=0.039)、重度DWMH(OR=7.058,P<0.001)、中重度BG-EPVS(OR=3.297,P=0.015)、CMB(OR=2.987,P=0.014)、CSVD总体负担(OR=2.062,P<0.001)与MPS显著相关。结论CSVD的影像学标记物以及整体负担,可能是小动脉硬化性CSVD患者MPS的标记物,提示MPS的发生与进展和血管病理损伤累积有关,可通过控制血管危险因素预防CSVD的进展,从而减少MPS的发生与进展。Objective Mild Parkinsonian signs(MPS)may be associated with cerebral small-vessel disease(CSVD).The aim of this study was to examine the association between imaging indicator,total burden and MPS in patients with CSVD.Methods Patients with arteriolosclerotic CSVD were retrospectively identified from March 2018 to August 2019.Vascular risk factors,hematological indicators and other clinical data,as well as the imaging characteristics were recorded.MPS was evaluated with the unified Parkinson's disease rating scaleⅢ(UPDRSⅢ).After adjusting for vascular risk factors such as age,gender and stroke history,multivariate Logistic regression analysis was performed to explore the relationship between CSVD imaging indicators,the total burden and MPS.Results A total of 98 subjects were included in the study,of which 45(48.9%)developed MPS.Multivariate Logistic regression analysis was used to estimate the relationship between each characteristics,overall burden of CSVD and MPS.We found that lacunes(OR=3.426,P=0.012),extensive PWMH(OR=2.946,P=0.039),extensive DWMH(OR=7.058,P<0.001),Moderate-extensive BG-EPVS(OR=3.297,P=0.015),CMBs(OR=2.987,P=0.014),and total CSVD burden(OR=2.062,P<0.001)were significantly associated with MPS.Conclusion The imaging markers and overall burden of CSVD may be the markers of MPS in patients with arteriolosclerotic CSVD,which suggesting that the occurrence and progression of MPS is related to the accumulation of vascular pathological damage.We can prevent the progression of CSVD by controlling vascular risk factors,thus reducing the occurrence and progression of MPS.

关 键 词：脑小血管病 轻度帕金森样体征 白质高信号 微出血 脑小血管病整体影像负担 

分 类 号：R743[医药卫生—神经病学与精神病学]