单侧颈内动脉狭窄患者侧支循环建立及脑血流量和认知功能的相关性  

Correlation of collateral circulation with CBF and cognitive function in patients with unilateral internal carotid artery stenosis

作　　者：胡晨 董瑞芳[1] 史方堃[1] 刘红梅[1] 姜东红[1] Hu Chen;Dong Ruifang;Shi Fangkun;Liu Hongmei;Jiang Donghong(Department of Neurology,Cangzhou Central Hospital,Cangzhou 061000,Hebei Province,China)

机构地区：[1]沧州市中心医院神经内科,061000

出　　处：《中华老年心脑血管病杂志》2022年第12期1296-1300,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：沧州市重点研发计划项目(172302141)。

摘　　要：目的研究血清血管生成素样蛋白(ANGPTL)2、ANGPTL8与单侧颈内动脉狭窄患者侧支循环建立及脑血流量(CBF)和认知功能的相关性。方法采取病例对照研究,选择2021年1月至7月在沧州市中心医院神经内科住院的重度单侧颈内动脉狭窄的缺血性脑血管病患者120例作为观察组,根据数字减影血管造影检查结果,将观察组又分为侧支循环不良组41例,侧支循环良好组79例;观察组依据蒙特利尔认知评估量表分为认知障碍组49例,认知正常组71例。另选取同期进行健康体检的志愿者120例作为对照组,比较各组不同认知功能及侧支循环情况、血清ANGPTL2、ANGPTL8水平及CBF、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)的差异,分析血清ANGPTL2、ANGPTL8、CBF与单侧颈内动脉狭窄患者侧支循环建立及认知功能的相关性。结果观察组患者的血清ANGPTL2、ANGPTL8水平显著高于对照组[(471.9±58.2)ng/L vs(271.3±59.2)ng/L,(1955.6±56.0)ng/L vs(663.5±55.0)ng/L,P<0.01];观察组患者的MTT、TTP显著高于对照组,CBV、CBF显著低于对照组(P<0.01)。认知障碍组患者的血清ANGPTL2、ANGPTL8水平显著高于认知正常组(P<0.01);认知障碍组患者的MTT、TTP显著高于认知正常组,CBV、CBF显著低于认知正常组(P<0.05,P<0.01)。侧支循环不良组血清ANGPTL2、ANGPTL8水平显著高于侧支循环良好组[(488.8±42.0)ng/L vs(463.1±42.7)ng/L,(2015.9±51.7)ng/L vs(1924.3±51.8)ng/L,P<0.01];侧支循环不良组患者的MTT、TTP显著高于侧支循环良好组,CBV、CBF显著低于侧支循环良好组。相关性分析显示,ANGPTL2、ANGPTL8与认知功能、侧支循环、MTT、TTP呈正相关,与CBV、CBF呈负相关。结论血清ANGPTL2、ANGPTL8与单侧颈内动脉狭窄患者侧支循环建立及CBF和认知功能呈显著相关性。Objective To determine the relationship of serum angiopoietin-like protein(ANGPTL)2 and ANGPTL8 with collateral circulation and the correlation with cerebral blood flow(CBF)and cognitive function in patients with unilateral internal carotid artery stenosis.Methods A case-control trail was carried out on 120 patients(observation group)suffering from ischemic cerebrovascular disease with severe unilateral internal carotid artery stenosis admitted in our department from January to July 2021.Another 120 volunteers taking physical examination during the same period were enrolled as the control group.According to the results of digital subtraction angiography,the patients of the observation group were divided into poor(n=41)and good collateral circulation subgroups(n=79).They were also assigned into cognitive impairment group(n=49)and normal cognitive group(n=71)according to the results of Montreal Cognitive Assessment Scale.The differences in cognitive functions and collateral circulation,serum ANGPTL2 and ANGPTL8 levels,CBF,cerebral blood volume(CBV),mean transit time(MTT)and time to peak(TTP)were compared between the control group and the observation group,and among the above subgoups.The correlation of serum ANGPTL2 and ANGPTL8 levels with collateral circulation and CBF and cognitive function in the patients with unilateral internal carotid artery stenosis was analyzed.Results The observation group had significantly higher serum ANGPTL2(471.9±58.2 ng/L vs 271.3±59.2 ng/L,P<0.01)and ANGPTL8(1955.6±56.0 ng/L vs 663.5±55.0 ng/L,P<0.01),obviously longer MTT and TTP(P<0.01),but notably lower CBV and CBF(P<0.01)when compared with the control group.Remarkably higher serum ANGPTL2 and ANGPTL8 levels(P<0.01),longer MTT and TTP and lower CBV and CBF(P<0.05,P<0.01)were observed in the patients with cognitive impairment than those with normal cognition.The serum ANGPTL2(488.8±42.0 ng/L vs 463.1±42.7 ng/L,P<0.01)and ANGPTL8 levels(2015.9±51.7 ng/L vs 1924.3±51.8 ng/L,P<0.01)were statistically higher in the poor than goo

关 键 词：颈动脉狭窄 侧支循环 脑血管循环 认知 

分 类 号：R743.3[医药卫生—神经病学与精神病学]