基于MRI分析帕金森病合并脑小血管病对患者认知功能的影响  

Analysis of the impact of Parkinson’s disease combined with cerebral small vessel disease on cognitive function based on MRI

作　　者：陈志 谭会会 李小波 张格娟 杨军乐 CHEN Zhi;TAN Huihui;LI Xiaobo;ZHANG Gejuan;YANG Junle(Department of Neurology,Xi’an Third Hospital,Xi’an 710000,China;Department of Radiology,Xi’an First Hospital,Xi’an 710000,China)

机构地区：[1]西安市第三医院神经内科,陕西西安710000 [2]西安市第一医院影像科,陕西西安710000

出　　处：《实用放射学杂志》2025年第3期359-363,共5页Journal of Practical Radiology

基　　金：西安市卫生健康委员会一般研究项目(2021yb35);西安市卫生健康委员会中医药科研项目(SZL202405)。

摘　　要：目的 基于 MRI分析影像学参数在不同认知功能帕金森病(PD)合并脑小血管病(CSVD)患者中的差异及相关性.方法 回顾性选取192例PD合并CSVD患者,根据蒙特利尔认知评估量表(MoCA)和简易精神状态量表(MMSE)评分,分为认知障碍PD组(n=69)与认知正常PD组(n=123),比较2组临床资料及 MRI影像学参数.结果 认知障碍PD组年龄、饮酒史高于认知正常PD组(P<0.05);认知障碍PD组可能血管源性腔隙(LPVO)评分、脑室周围白质高信号(PVWMH)评分、基底节区血管周围间隙(BG-PVS)评分、脑萎缩(BA)评分、CSVD总评分高于认知正常PD组(P<0.05),2组深部白质高信号(DWMH)评分、半卵圆中心血管周围间隙(CS-PVS)评分、脑微出血(CMB)评分差异无统计学意义(P>0.05);多因素logistic分析显示年龄、LPVO评分、BG-PVS评分、BA评分、CSVD总评分是认知功能障碍独立的影响因素(P<0.05).结论 影像学参数LPVO评分、PVWMH评分、BG-PVS评分、BA评分、CSVD总评分在不同认知功能PD合并CSVD患者中存在差异,且与 MMSE评分和 MoCA评分有相关性.Objective To analyze the differences and correlations of imaging parameters in patients with Parkinson’s disease(PD)combined with cerebral small vessel disease(CSVD)with different cognitive functions based on MRI.Methods A retrospective selection was conducted on 192 PD patients combined with CSVD.According to the Montreal cognitive assessment(MoCA)and mini-mental state examination(MMSE)scores,they were divided into cognitive impairment PD group(n=69)and cognitive normal PD group(n=123),and the clinical data and MRI imaging parameters of the two groups were compared.Results The age and drinking history of the cognitive impairment PD group were higher than those of the cognitive normal PD group(P<0.05);the lacune of presumed vascular origin(LPVO)score,periventricular white matter hyperintensity(PVWMH)score,basal ganglia-perivascular space(BG-PVS)score,brain atrophy(BA)score,and CSVD total score in the cognitive impairment PD group were higher than those in the cognitive normal PD group(P<0.05),while there was no statistically significant difference in deep white matter hyperintensity(DWMH)score,centrum semiovale perivascular space(CS-PVS)score,and cerebral microbleed(CMB)score between the two groups(P>0.05);Multivariate logistic analysis showed that age,LPVO score,BG-PVS score,BA score,and CSVD total score were independent influencing factors of cognitive impairment(P<0.05).Conclusion There are differences in imaging parameters such as LPVO score,PVWMH score,BG-PVS score,BA score,and CSVD total score among PD patients combined with CSVD with different cognitive functions,and they are correlated with MMSE and MoCA scores.

关 键 词：帕金森病 脑小血管病 磁共振成像 认知功能障碍 

分 类 号：R742[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学] R445.2