重度纹状体区扩大的血管周围间隙与运动功能障碍的相关性研究  

Relationship between severely enlarged perivascular spaces and motor dysfunction in striatum

作　　者：杨淑娜[1] 秦伟[1] 杨磊[1] 李悦[1] 李譞婷 胡文立[1] Yang Shuna;Qin Wei;Yang Lei;Li Yue;Li Xuanting;Hu Wenli(Department of Neurology,Affiliated Beijing Chaoyang Hospital of Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院神经内科,100020

出　　处：《中华老年心脑血管病杂志》2020年第12期1243-1246,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81271309);北京市科技计划项目(Z171100001017073)。

摘　　要：目的探究重度纹状体区扩大的血管周围间隙(EPVS)与运动功能障碍的关系。方法选择重度纹状体区EPVS(单侧纹状体EPVS≥20个或数量无法数清)患者48例为EPVS组,另选择健康体检者48例为对照组(单侧纹状体EPVS<20个)。采用Barthel指数、简明运动试验(SPPB)、Tinetti量表、“起立-行走”计时测试(TUG)评估受试者日常生活能力及运动功能。Fazekas量表评估脑白质高信号(WMH)严重程度。比较EPVS组与对照组运动功能差异,Spearman相关性和多重线性回归分析重度纹状体区EPVS与运动功能障碍的关系。结果EPVS组TUG用时明显高于对照组,SPPB总分、SPPB步行速度测试、SPPB坐站测试、Tinetti量表总分、Tinetti步态、Tinetti平衡和步行速度明显低于对照组(P<0.01)。Spearman相关性分析显示,重度纹状体区EPVS与SPPB总分、SPPB步行速度测试、SPPB坐站测试、Tinetti平衡量表总分、Tinetti步态、Tinetti平衡和步行速度呈负相关(P<0.01),校正WMH程度和腔隙后,相关性仍有统计学意义(P<0.05,P<0.01)。多重线性回归分析显示,WMH程度和重度纹状体区EPVS是Tinetti步态(95%CI:-1.131^-0.722,P=0.001;95%CI:-1.242^-0.112,P=0.019)、Tinetti平衡(95%CI:-1.459^-0.858,P=0.001;95%CI:-2.199^-0.539,P=0.001)和步行速度(95%CI:-0.096^-0.064,P=0.001;95%CI:-0.135^-0.049,P=0.001)的独立危险因素。结论重度纹状体区EPVS是步态异常、平衡能力下降、步行速度减慢的独立危险因素,与日常生活能力下降无关。Objective To study the relationship between severely enlarged perivascular spaces(EPVS)and motor dysfunction in striatum.Methods Forty-eight patients with severely EPVS≥20 or uncountable perivascular spaces in unilateral striatum served as an EPVS group.48 persons who underwent physical examination served as a control group.Their daily life ablility and motor function were assessed according to their Barthel index,short physical performance battery(SPPB)test parameters,Tinetti scale score,and time up and go(TUG)test parameters respectively.The severity of white matter hyperintensities(WMH)was assayed according to their Fazekas scale score.The motor function was compared between EPVS group and control group.The relationship between severely EPVS and motor dysfunction in striatum was analyzed by Spearman correlation analysis and multivariate linear regression analysis respectively.Results The time of TUG test was significantly longer in EPVS group than in control group(P<0.01).The total SPPB test score,SPPB test walking speed score,SPPB test sitting and standing score,total Tinetti scale score,Tinetti scale gait score,Tinetti scale balance score and Tinetti scale walking speed score were significantly lower in EPVS group than in control group(P<0.01).Spearman correlation analysis showed that severely EPVS in striatum were negatively related with the total SPPB test score,SPPB test walking speed score,SPPB test sitting and standing score,total Tinetti scale score,Tinetti scale gait score,Tinetti scale balance score and Tinetti scale walking speed score after adjustment for WMH and lacune(P<0.05,P<0.01).Multivariate linear regression analysis demonstrated that severely EPVS in striatum were an independent risk factor for Tinetti scale gait score(95%CI:-1.131--0.722,P=0.001;95%CI:-1.242--0.112,P=0.019),Tinetti scale balance scale score(95%CI:-1.459--0.858,P=0.001;95%CI:-2.199--0.539,P=0.001)and Tinetti scale walking speed score(95%CI:-0.096^-0.064,P=0.001;95%CI:-0.135^-0.049,P=0.001)after adjustment for WMH and lacu

关 键 词：运动障碍 脑白质病 步行速度 大脑小血管疾病 

分 类 号：R743[医药卫生—神经病学与精神病学]