多发性大动脉炎轻症患者脑血流动力学变化及与认知功能改变的相关性研究  

Study on Correlation Between Cerebral Hemodynamic and Cognitive Function Changes in Patients with Mild Takayasu Arteritis

作　　者：吴党洁 陈定章 徐晖 李昱茜 郑敏娟 WU Dangjie;CHEN Dingzhang;XU Hui;LI Yuxi;ZHENG Minjuan(Department of Medical Ultrasonics,The First Affiliated Hospital of Air Force Medical University,Xi’an Shaanxi 710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院超声医学科,陕西西安710032

出　　处：《中国医疗设备》2022年第8期8-11,共4页China Medical Devices

基　　金：陕西省重点研发计划(2022KWZ-19)。

摘　　要：目的探讨多发性大动脉炎(Takayasu Arteritis,TA)轻症患者疾病活动性与脑血流动力学和认知功能的变化关系及临床意义。方法选取2017年8月至2020年8月于我院就诊的轻症TA患者67例(TA组)与健康体检者60名(对照组)。所有受试者均采用经颅彩色多普勒测量颅内大血管的收缩期峰值血流速度(Peak Systolic Velocity,PSV)、舒张末期血流速度(End Diastolic Velocity,EDV)、搏动指数(Pulsatility Index,PI)、阻力指数(Resistance Index,RI)。采用简易精神状态评价量表(Mini-Mental State Examination,MMSE)评估MMSE总分。依据Kerr评分评估TA组疾病活动性,分析TA活动性与脑血流及认知的关系。结果轻症TA患者右侧大脑中动脉(Middle Cerebral Artery,MCA)和基底动脉的PSV、RI、PI,双侧椎动脉的PSV、EDV、RI、PI,左侧MCA的PSV,左侧大脑后动脉的PI值均高于对照组(P<0.05);另外,轻症TA患者的MMSE总分明显低于对照组(P<0.05),且与Kerr评分呈负相关(r=-0.665,P<0.05),而Kerr评分与脑血流动力学各参数无显著相关性;轻症TA患者脑血流异常参数综合与MMSE总分呈显著性相关(r=0.539,P<0.05)。结论轻症TA患者未出现明显血管狭窄时,脑血流动力学参数及认知功能已出现异常,且随着疾病活动性的加重,认知功能损害也加重,提示临床需尽早关注轻症TA患者脑血流动力学和认知功能改变,及时干预以改善患者预后。Objective To investigate the relationship between disease activity,cerebral hemodynamic changes and cognitive function in mild Takayasu arteritis(TA)patients and its clinical significance.Methods A total of 67 mild TA patients admitted to our hospital from August 2017 to August 2020(TA group)and 60 healthy volunteers(control group)were selected.All subjects received transcranial color Doppler to measure the peak systolic velocity(PSV),end diastolic velocity(EDV),pulsatility index(PI)and resistance index(RI)of intracranial large vessels.The Mini-mental state examination(MMSE)was used to assess the total MMSE scores.The TA group was consider evaluated for disease activity according to the Kerr score,and the relationship between TA activity and cerebral hemodynamic and cognitive function were assessed.Results The PSV,RI,PI of basilar artery and middle cerebral artery(MCA)on the right side,the PSV,EDV,RI,PI of bilateral vertebral artery,PSA of MCA on the left side and PI of posterior cerebral artery on the left side were all higher than those of the control group(P<0.05).In addition,the MMSE score of the TA group was significantly lower than that of the control group(P<0.05),and was negatively correlated with the Kerr score(r=-0.665,P<0.05),while Kerr score had no significant correlation with cerebral hemodynamic parameters.The comprehensive abnormal parameters of cerebral blood flow in patients with mild TA were significantly correlated with the MMSE scores(r=0.539,P<0.05).Conclusion For mild TA patients,although there was no apparent vascular stenosis,cerebral hemodynamics parameters and cognitive function showed impaired.With the aggravation of disease activity,the cognitive impairment is also aggravated,suggesting that attention should be paid to the changes of cerebral hemodynamics and cognitive function in TA patients as soon as possible,and timely intervention should be needed to improve the prognosis of TA patients.

关 键 词：颅内血管 多发性大动脉炎 脑血流动力学 认知功能 

分 类 号：R543.5[医药卫生—心血管疾病]