脑血管病患者血管因素与认知功能障碍的相关性  

Correlation between vascular factors and cognitive dysfunction in patients with cerebrovascular disease

作　　者：朱雅文 潘虹[1] 席从林 陈锐 ZHU Yawen;PAN Hong;XI Conglin(Department of Neurology,Huai’an Second People’s Hospital,Anhui,Huai’an 223001,China;不详)

机构地区：[1]江苏省淮安市第二人民医院神经内科,223001 [2]江苏省淮安市第二人民医院肿瘤科,223001

出　　处：《河北医药》2023年第13期1991-1994,共4页Hebei Medical Journal

基　　金：淮安市科技项目(编号:HAB201932)。

摘　　要：目的探讨脑血管病患者血管因素与认知功能障碍的相关性。方法回顾性选取2020年3月至2022年7月神经内科住院治疗的缺血性脑卒中患者126例,将患者分为≥蒙特利尔评估量表(MoCA)分界值组(48)例和<MoCA分界值组(78例),同期选取健康人群100例为对照组,均行认知功能评估、经颅多普勒超声检查和颅内大动脉硬化程度评估,分析认知功能与血管因素的相关性。结果≥MoCA分界值组和<MoCA分界值组的Vmax、Vmin、Vmean均明显低于对照组(P<0.05),而<MoCA分界值组PI高于对照组(P<0.05);<MoCA分界值组的Vmax、Vmin、Vmean均显著低于≥MoCA分界值组(P<0.05);<MoCA分界值组颅内大动脉硬化程度显著高于≥MoCA分界值组,差异有统计学意义(P<0.05);脑卒中患者MoCA评分与PI、颅内大动脉硬化程度呈负相关,而与Vmax、Vmin、Vmean呈正相关(P<0.05);脑卒中患者MoCA评分与PI、颅内大动脉硬化程度呈负相关,而与Vmax、Vmin、Vmean呈正相关(P<0.05)。结论缺血性脑卒中患者脑血管血流动力学改变与认知功能损伤密切相关,PI、颅内大动脉硬化程度是引发脑卒中患者认知功能障碍的高风险因素。Objective To investigate the correlation between vascular factors and cognitive dysfunction in patients with cerebrovascular disease.Methods A total of 126 patients with ischemic stroke admitted in the Department of Neurology from March 2020 to July 2022 were retrospectively selected.They were divided into≥MoCA(Montreal Cognitive Assessment)cut-off value group(n=48)and<MoCA cut-off value group(n=78),and 100 homochronous healthy volunteers were included in the control group.Cognitive function assessment,transcranial Doppler ultrasonography and intracranial large arteriosclerosis assessment were performed in all subjects.The correlation between cognitive function and vascular factors in patients with cerebrovascular disease was identified.Results The maximum velocity(Vmax),minimum velocity(Vmin)and mean velocity(Vmean)in the≥MoCA cut-off value group and the<MoCA cut-off value group were significantly lower than those in the control group(P<0.05),while the pulsatility index(PI)in the<MoCA cut-off value group was significantly higher than that in the control group(P<0.05).The Vmax,Vmin and Vmean of the<MoCA cut-off group were significantly lower than those of the≥MoCA cut-off group(P<0.05).The arteriosclerosis degree of intracranial large vessels in the<MoCA cut-off group was significantly worse than that in the≥MoCA cut-off group(P<0.05).MoCA score of stroke patients was negatively correlated with PI and the degree of intracranial arteriosclerosis,but positively correlated with Vmax,Vmin,and Vmean(P<0.05).Conclusion The changes of cerebrovascular hemodynamics in patients with ischemic stroke are closely related to cognitive impairment.PI and the degree of intracranial arteriosclerosis are high-risk factors for cognitive dysfunction in stroke patients.

关 键 词：缺血性脑卒中 脑血管因素 认知功能障碍 动脉硬化 

分 类 号：R742[医药卫生—神经病学与精神病学]