慢性脑供血不足患者局部脑血流异常与认知功能障碍的关系研究

Relationship study between regional cerebral blood flow abnormality and cognitive dysfunction in patients with chronic cerebral circulatory insufficiency

目的探讨慢性脑供血不足患者局部脑血流异常与认知功能障碍的关系。方法选择本院收治的慢性脑供血不足患者30例为研究对象,选择同期健康体检者30例为对照组,采用简易智能状况量表(MMSE)、画钟表测验(CDT)、Fild物体记忆测验(FOM)评定两组认知功能;全部对象行多层螺旋CT脑灌注成像,采用感兴趣区(ROI)方法观察大脑各部位局部脑血流量(r CBF),并进行组间比较,分析患者各项认知功能评分与r CBF的关系。结果研究组MMSE、CDT、FOM评分明显低于对照组,差异均有统计学意义(P<0.05);研究组额叶、颞叶、顶叶、丘脑、小脑、脑干r CBF明显低于对照组,差异有统计学意义(P<0.05);两组枕叶、基底节r CBF比较差异无统计学意义(P>0.05);慢性脑供血不足患者MMSE评分与颞叶、顶叶r CBF呈正相关(r=0.472、0.358,P<0.05),CDT评分与额叶、顶叶r CBF呈正相关(r=0.349、0.451,P<0.05);FOM评分与颞叶、顶叶r CBF呈正相关(r=0.317、0.325,P<0.05)。结论慢性脑供血不足患者存在不同程度的认知功能障碍,认知功能障碍程度与r CBF相关,可见相关区域r CBF减少可能是导致认知功能障碍的重要原因,临床应及早干预。

Objective To investigate the relationship between regional cerebral blood flow abnormality and cognitive dysfunction in patients with chronic cerebral circulatory insufficiency（CCCI）. Methods 30 patients with CCCI admitted to our hospital were selected for study group,and 30 cases of healthy people in the same period were selected as control group,the mini-mental state examination（MMSE）,clock drawing task（CDT）,fild object memory test（FOM）were used to assess cognitive function of two groups;All objects were given multislice CT brain perfusion imaging,regions of interest（ROI）method was used to observe various parts of brain regional cerebral blood flow（r CBF）.The relationship between cognitive function scores and r CBF of CCCI patients were analyzed. Results MMSE,CDT,FOM scores of study group was significantly lower than that of control group respectively,with statistical difference（P〈0.05）.The frontal lobe,temporal lobe,parietal lobe,thalamus,cerebellum,brainstem r CBF of study group was significantly lower than that of control group respectively,with statistical difference（P〈0.05）.Occipital lobes,basal ganglia r CBF in two groups was compared respectively,with no statistical difference（P〉0.05）.Correlation analysis showed that MMSE score of CCCI patients was positively related with and temporal lobe,parietal lobe r CBF respectively（r=0.472,0.358,P〈0.05）.CDT score was positively related with frontal lobe,parietal lobe r CBF respectively（r=0.349,0.451,P〈0.05）.FOM score was positively related with temporal lobe,parietal lobe r CBF respectively（r=0.317,0.325,P〈0.05）. Conclusion Patients with CCCI has varying degrees of cognitive impairment,cognitive impairment degree is related with r CBF,so locally relevant r CBF reduction be an important cause of cognitive dysfunction,should given early clinical intervention.