脑小血管病总负荷与记忆力下降老年患者认知功能、脑萎缩及脑灌注的相关性  

Correlation between the Total Cerebral Small Vessel Disease Load and Cognitive Function,Brain Atrophy and Cerebral Perfusion in Patients with Memory Loss

作　　者：王结群 吴毅泰 王星[1] 徐晟 李任任 聂志余[1] 李云霞[1] WANG Jie-Qun;WU Yi-Tai;WANG Xing;XU Sheng;LI Ren-Ren;NIE Zhi-Yu;LI Yun-Xia(Department of Neurology,Tongji Hospital,Shanghai 200065,China;Community Health Service Center of Ganquan Street,Putuo District,Shanghai 200065,China)

机构地区：[1]上海市同济医院神经内科,上海200065 [2]上海市普陀区甘泉街道社区卫生服务中心

出　　处：《中国卒中杂志》2020年第12期1276-1280,共5页Chinese Journal of Stroke

基　　金：国家自然科学基金(81671307);上海市重中之重临床重点学科(2017ZZ02020)。

摘　　要：目的探索脑小血管病(cerebral small vessel disease,CSVD)总负荷与记忆力下降老年患者认知功能、脑萎缩及脑灌注的关系。方法回顾性纳入2015年12月-2017年12月同济医院神经内科门诊及记忆减退专病门诊主诉记忆力下降患者,收集一般资料及影像学信息,进行认知评估、CSVD总负荷评分、全脑及各脑叶脑萎缩评分,计算脑血流(cerebralbloodflow,CBF)值。采用Spearman相关分析CSVD总负荷评分与认知功能、脑萎缩及CBF的关系。结果共纳入200例,平均年龄69.16±9.44岁,男性99例(49.5%)。CSVD总负荷与MoCA评分呈负相关(r=-0.202,P=0.004);与全脑(r=-0.234,P=0.001)、额叶(r=-0.252,P<0.001)、顶叶(r=-0.253,P<0.001)、枕叶(r=-0.224,P=0.001)CBF呈负相关;CSVD负荷与全脑(r=0.313,P<0.001)、额叶(r=0.393,P<0.001)及顶叶(r=0.237,P=0.001)的脑萎缩评分呈正相关。结论CSVD总负荷越高,认知功能越差、脑灌注越低、脑萎缩越严重。Objective To investigate the correlation between the total cerebral small vessel disease(CSVD)load and cognitive function,brain atrophy and cerebral perfusion in patients with memory loss.Methods The outpatients with memory loss in the Department of Neurology and Memory Clinic of Tongji Hospital were retrospectively included in this study.The collected data included the general information and imaging results,cognitive assessment(MoCA score),the total CSVD load,the atrophy score of the whole brain and each lode,and cerebral blood flow(CBF)of the whole brain and each lobe.Spearman correlation analysis was used to analyze the relationship between the total CSVD load and cognitive function,brain atrophy and CBF.Results A total of 200 patients were included,with a mean age of 69.16±9.44 years old and 99 males(49.5%).The total CSVD load was negatively correlated with MoCA score(r=-0.202,P=0.004),and CBF of the whole brain(r=-0.234,P=0.001),frontal lobe(r=-0.252,P<0.001),parietal lobe(r=-0.253,P<0.001),and occipital lobe(r=-0.224,P=0.001).The total CSVD load was positively correlated with the atrophy scores of the whole brain(r=0.313,P<0.001),frontal lobe(r=0.393,P<0.001)and parietal lobe(r=0.237,P=0.001).Conclusions The higher the CSVD load,the worse the cognitive function,the lower cerebral perfusion,and the more severe the brain atrophy.

关 键 词：脑小血管病总负荷 认知功能 脑灌注 脑萎缩 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]