老年性痴呆伴脑白质疏松症患者认知功能损害的研究

Cognitive impairment in patients of Alzheimer's disease with leukoaraiosis

目的探讨阿尔茨海默病(AD,又称为老年性痴呆)伴脑白质疏松症(LA)患者认知功能损害情况。方法收集AD患者51例,与51例无认知功能下降者对照研究,检测受试者血压、血糖、血脂、体重指数等指标,并收集其吸烟、受教育程度等信息,通过头颅MRI检查确定是否存在LA,对比分析AD伴发LA的危险因素。再进一步比较AD组伴LA和不伴LA患者认知功能下降情况。认知功能检测用简易智能量表(MMSE)。结果与对照组比较,AD患者平均受教育程度更低,分别为4.7、6.2年(P<0.01);原发性高血压患者比例更高,分别为62.7%、47.1%(P<0.01);而且更易发生LA,分别为47.1%、14.6%(P<0.01)。AD伴LA 24例,与不伴LA 27例患者比较,伴LA者患原发性高血压、冠心病、颈动脉狭窄比例更高,而且认知功能下降程度更明显,MMSE分别为14.2、18.2分(P<0.01),以记忆力(2.7、4.4分)和语言行为(3.7、5.1分)功能下降为主。结论提示原发性高血压、冠心病和颈动脉狭窄是AD伴LA发生的可能危险因素,LA的发生加重AD的认知功能损害。

Objective To study the risk factors of Alzheimer＇s disease with leukoaraiosis （LA）,as well as the impact of 1.A on cognitive impairment. Methods We enrolled 51 cases of patients of AD and 51 cases of normal elderly control as subjects. We re corded blood pressure,blood glucose,blood lipids,smoking, body mass index,educational level and other information of subjects, and determined the existence of LA through the head MRI examination. Results Compared with normal control group, patients with Alzheimer disease had lower levels of education （4.7 years vs 6.2 years, P^0.01）, higher proportion of hypertensive （62.7 vs 47.1%,P^0.01） and more leukoaraiosis （47.1% vs 14.6% ,P〈~0.01）. Compared with 27 cases of patients without LA,24 ca ses of AD with LA showed more incidence of hypertension,coronary heart disease,and carotid artery stenosis and worsen cognitive function （MMSE score 14.2 points vs 18.2 minutes,P〈0.01） ,the decline of memory （2.7 points vs 4.4 points） and language a bility （3.7 points vs 5.1 points） was more obvious. Conclusion Our study suggests hypertension,coronary heart disease and carot id artery stenosis are possible risk factors of AD with LA. LA may Aggravate cognitive impairment of AD.