47例脑小血管病患者脑血流动力学与认知功能损害的相关性研究

Abstract

目的：探讨脑小血管病患者脑血流动力学改变与认知功能损害的相关性。方法：连续纳入2015年6月至2016年3月就诊于兰州军区乌鲁木齐总医院干三科的经MRI诊断的脑小血管病患者，经CTA、MRA排除大动脉狭窄后，对其进行经颅多普勒(Trans cranial Doppler, TCD)监测和事件相关电位(Event-related potential, ERP)检查，结合神经心理学量表(Montreal Cognitive Assessment, MOCA和Mini-Mental State Examination, MMSE)检测评价其脑血流动力学参数与认知动能相关性。结果：47例患者中，男性80.9%，年龄65.17 ± 10.68岁，MOCA评分：23.70 ± 5.46分，MMSE评分：26.38 ± 3.37分。Cz位置P3潜伏期：346.87 ± 34.12 ms；Pz位置P3潜伏期：346.66 ± 35.14 ms。通过多元逐步回归分析，TCD指标中左侧大脑中动脉RI与ERP中Cz位置P3潜伏期及Pz位置P3潜伏期均有明显相关性(P < 0.05)。结论：脑血流动力学的改变对脑小血管病患者的认知功能有明显影响，脑血流动力学TCD检测结果可能成为评判脑小血管病患者认知功能下降早期、无创、简便的筛查方法。 Objective: To explore the correlation of cerebral hemo-dynamics and cognitive function in pa-tients with cerebral small vessel diseases (CSVD). Methods: Clinical data were collected in consecutive patients who visited the gerontology department in Xinjiang Urumqi Military General Hospital from June 2015 to March 2016 and were diagnosed with CSVD after exclusion of large cerebral vascular disease by CTA or MRA. Cerebral hemo-dynamics were assessed using Transcranial Doppler, while cognitive function was assessed by neuropsychological scale and event-related potential. Then the correlations were analyzed. Results: Of the 47 patients included, 80.9% were male, aged 65.17 ± 10.68 years. Cognitive function in Montreal Cognitive Assessment (MOCA) was mildly abnormal with scores of 23.70 ± 5.46, and Mini-Mental State Examination (MMSE) scores were 26.38 ± 3.37. The P3 latencies of Cz and Pz were 346.87 ± 34.12 ms and 346.66 ± 35.14 ms respectively. There was significantly correlation between RI of left middle cerebral artery with P3 latency of Cz and Pz among these patients (P < 0.05). Conclusion: The cognitive function was significantly affected by cerebral hemo-dynamics in patients with CSVD. The TCD examination of cerebral hemo-dynamics could be an early, noninvasive and simple screening method for cognitive function decline in patients with CSVD.