VCIND与认知正常脑血管病变患者脑血管形态学及血清指标差异分析  

Analysis of the difference of cerebral vascular morphology and serum indexes between patients with VCIND and cognitively normal cerebral vascular disease

作　　者：章涛 郑云华[2] 刘烨 姜腾波[2] 雷修玲 江桂珍 徐静波[2] ZHANG Tao;ZHENG Yunhua;LIU Ye;JIANG Tengbo;LEI Xiuling;JIANG Guizhen;XU Jingbo(Graduate School of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China;Department of Neurology,Quzhou Hospital of Zhejiang Medical and Health Group(Zhejiang Quhua Hospital),Quzhou 324000,Zhejiang,China)

机构地区：[1]浙江中医药大学研究生院,浙江杭州310053 [2]浙江省医疗健康集团衢州医院(浙江衢化医院)神经内科,浙江衢州324000

出　　处：《中国现代医生》2025年第10期11-15,共5页China Modern Doctor

基　　金：浙江省衢州市指导性科技攻关项目(2023ZD002)。

摘　　要：目的探讨非痴呆型血管性认知功能障碍(vascular cognitive impairment no dementia,VCIND)与认知正常脑血管病变患者的脑血管形态学及血清指标差异。方法选取2023年6月至2024年9月于浙江省医疗健康集团衢州医院住院的VCIND患者100例纳入试验组,选取同期住院的认知正常的脑血管病变患者100例纳入对照组,采用全脑血管造影及血清检查,比较两组患者的脑动脉延长扩张、脑血管狭窄、侧支循环建立、炎症因子、血脂代谢指标,并探究试验组不同责任血管病变与认知障碍严重程度的关系。结果试验组患者的脑动脉延长扩张率、血管狭窄率高于对照组,侧支循环建立率低于对照组(P<0.05);试验组患者的白细胞介素-6、白细胞介素-1β、肿瘤坏死因子-α、总胆固醇、低密度脂蛋白、载脂蛋白B及脂蛋白a水平均显著高于对照组,高密度脂蛋白水平低于对照组(P<0.05);试验组患者大脑前动脉血管病变20例,大脑中动脉血管病变22例,大脑后动脉血管病变26例,椎基底动脉血管病变32例,不同责任血管病变患者的简易精神状况检查量表评分、蒙特利尔认知评估量表评分、Hachinski缺血量表评分比较差异均无统计学意义(P>0.05)。结论脑动脉延长扩张、脑动脉狭窄、无侧支循环建立、炎症反应及血脂代谢异常的患者是发生VCIND的高危人群,此类患者需早期进行认知干预,预防VCIND发生。Objective To investigate the differences of cerebral vascular morphology and serum indexes between patients with vascular cognitive impairment no dementia(VCIND)and cognitively normal cerebral vascular disease.Methods A total of 100 VCIND patients hospitalized in Quzhou Hospital of Zhejiang Medical and Health Group from June 2023 to September 2024 were included in experimental group,and 100 cognitively normal patients with cerebral vascular disease hospitalized during the same period were included in control group.Cerebral artery extension and dilation,cerebrovascular stenosis,collateral circulation establishment,inflammatory factors and lipid metabolism indexes were compared between two groups by means of cerebrovascular angiography and serum examination.The relationship between the severity of cognitive impairment and the vascular lesion of different responsibility was also explored.Results The rate of cerebral artery extension and dilation,rate of vascular stenosis in experimental group were higher than those in control group,and the rate of collateral circulation establishment was lower than that in control group(P<0.05).The levels of interleukin-6,interleukin-1β,tumor necrosis factor-α,total cholesterol,low density lipoprotein,apolipoprotein B and lipoprotein(a)in experimental group were significantly higher than those in control group,level of high density lipoprotein was lower than that in control group(P<0.05).In experimental group,there were 20 cases of anterior cerebral artery vascular disease,22 cases of middle cerebral artery vascular disease,26 cases of posterior cerebral artery vascular disease,32 cases of vertebrobasilar artery vascular disease.There were no significant differences in the scores of mini-mental state examination,Montreal cognitive assessment and Hachinski ischemic scale among patients with different responsible vascular diseases(P>0.05).Conclusion Patients with cerebral artery extension and dilation,cerebral artery stenosis,no establishment of collateral circulation,inflammatory r

关 键 词：非痴呆型血管性认知功能障碍 认知功能 脑血管形态学 

分 类 号：R743.9[医药卫生—神经病学与精神病学]