眼底血管病变与脑小血管病及认知功能的相关性研究  

Associations of fundus vasculopathy with cerebral small vessel disease and cognitive impairment

作　　者：侯雨桐 杨磊[1] 杨淑娜[1] 秦伟[1] 崔春梅[2] 李迎[2] 胡文立[1] Hou Yutong;Yang Lei;Yang Shuna;Qin Wei;Cui Chunmei;Li Ying;Hu Wenli(Department of Neurology,Beijing Chaoyang Hospital,Capital Medical University,Beijing100021,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 [2]首都医科大学附属北京朝阳医院眼科,100020

出　　处：《中华老年心脑血管病杂志》2024年第5期552-556,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探究脑小血管病(CSVD)总负担与眼底血管病变的相关性及眼底血管病变对CSVD相关认知功能障碍的评价意义。方法连续纳入2021年5月至2022年8月在北京朝阳医院神经内科病房查体的健康受试者290例,根据CSVD总负担评分进行分组,分为0分组129例,1分组51例,2分组42例,3分组44例,4分组24例。受试者完成头部MRI检查、眼底荧光造影及认知功能评估,并对CSVD总负担和眼底血管病变进行评价。比较不同CSVD总负担评分组间一般临床资料、化验指标、眼底血管情况及认知功能的差异。用Spearman相关性分析及线性相关分析探究眼底血管病变与CSVD总负担及认知功能的相关性。结果不同CSVD总负担组年龄、受教育年限、脑梗死/TIA、总胆固醇、低密度脂蛋白胆固醇、肌酐、蒙特利尔认知评估量表评分、简易智能状态检查量表评分、连线试验、数字符号转换试验、Stroop色词干扰试验、语言流畅性测试、视网膜中央动脉等效值(CRAE)、视网膜中央静脉等效值(CRVE)、动静脉比值(AVR)、Scheie分级、深部白质高信号、脑室旁白质高信号、基底节区扩大的血管周围间隙、腔隙、脑微出血等比较,差异有统计学意义(P<0.05,P<0.01)。Spearman相关性分析显示,CSVD总负担与CRAE、AVR呈负相关(r=-0.655,P=0.000;r=-0.679,P=0.000),与CRVE、Scheie分级呈正相关(r=0.560,P=0.000;r=0.685,P=0.000)。多因素线性分析显示,校正相关危险因素后CRAE、CRVE、AVR、Scheie分级与CSVD总负担显著相关(P<0.01),且与认知功能障碍存在相关性。结论眼底血管病变与CSVD总负担增加密切相关,可作为探究CSVD相关认知功能障碍的有效指标。Objective To investigate the correlation between the total CSVD burden and fundus vasculopathy,and evaluate significance of fundus vasculopathy for cognitive impairment in CSVD patients.Methods A total of 290inpatients who taking physical examination in our department from May 2021to August 2022were consecutively recruited,and according to their score of CSVD,they were divided into group 0(129cases),group 1(51case),group 2(42cases),group 3(44cases),and group 4(24cases).All the subjects underwent brain magnetic resonance imaging,fundus fluorescein angiography,and cognitive function assessment.The total CSVD burden and fundus vasculopathy were evaluated.The general clinical data,results of laboratory tests,fundus vascularization,and cognitive function were compared among the groups with different CSVD burden scores.Spearman correlation analysis and linear correlation analysis were used to explore the correlation between total CSVD burden score and fundus vascular disease.Results Significant differences were observed in terms of age,years of education,cerebral infarction/TIA,total cholesterol,LDL-C,creatinine,MoCA and MMSE scores,positive results of connectivity test,digitsymbol conversion test,Stroop colour-word interference test and verbal fluency test,values of CRAE,CRVE,AVR,Scheie grade,DWMH and PVWMH,enlarged perivascular space in the basal ganglia(BG-EPVS),lacunar infarct and cerebral microbleeds(CMB)in different CSVD total burden groups(P<0.05,P<0.01).Spearman correlation analysis showed that total CSVD burden was negatively correlated with CRAE and AVR(r=-0.655,P=0.000;r=-0.679,P=0.000),and positively with CRVE and Scheie grade(r=0.560,P=0.000;r=0.685,P=0.000).Multivariate linear analysis showed that the total CSVD burden after adjusting for relevant risk factors was significantly correlated with CRAE,CRVE,AVR and Scheie grades(P<0.01).Conclusion Fundus vasculopathy is strongly associated with increased total CSVD burden,and it can be regarded as a valid predictor of CSVD-related cognitive impairment.

关 键 词：大脑小血管疾病 认知 数据相关性 眼底血管病变 脑小血管病总负担 

分 类 号：R743[医药卫生—神经病学与精神病学]