经颅超声多普勒对原发性帕金森病脑动脉硬化的评价及其与患者认知功能障碍的相关性研究

The Relationship between Primary Cerebral Arteriosclerosis in Parkinson Disease and Cognitive Impairment in Patients with Transcranial Doppler Ultrasonography

目的:探讨经颅超声多普勒(TCD)对原发性帕金森病脑动脉硬化的评价价值及其与患者认知功能障碍的相关性研究。方法:选择2011年1月至2013年6月神经内科和帕金森专病门诊诊治的原发性帕金森病患者158例作为研究组,所有患者行经颅多普勒超声检查以评定脑动脉硬化情况,并选择同期体检健康人60例作为对照组。应用蒙特利尔认知评估量表(Mo CA)测试两组认知功能。结果:研究组中患者伴脑动脉硬化64例,占40.5%。帕金森伴脑动脉硬化组MCA和BA PI、RI显著高于帕金森不伴脑动脉硬化组和对照组,Vm、Vd显著低于帕金森不伴脑动脉硬化组和对照组(P<0.05)。帕金森伴脑动脉硬化组、帕金森不伴脑动脉硬化组Mo CA各项得分及总分显著低于对照组,帕金森伴脑动脉硬化组Mo CA各项得分及总分显著低于帕金森不伴脑动脉硬化组(P<0.05)。相关性分析显示Mo CA总分与大脑基底动脉(BA)、大脑中动脉(MCA)搏动指数(PI)、阻力指数(RI)呈负相关(r=-0.354,-0.276,-0.307,-0.235,均P<0.05)。结论:帕金森病患者认知功能障碍与脑动脉硬化有密切的关系,通过TCD评价患者脑动脉硬化情况对原发性帕金森病认知功能障碍诊断具有一定价值。

Objective： To investigate the relationship between primary cerebral arteriosclerosis in Parkinson disease and cognitive impairment in patients with transcranial doppler ultrasonography. Method： Selected 158 cases of idiopathic Parkinson＇s disease from 2011 January to 2013 June in our hospital as the study group,all the patients underwent transcranial Doppler ultrasound to assess cerebral arteriosclerosis,and 60 cases of healthy people were selected as the control group. Applied Montreal cognitive assessment scale（ MoCA） to test cognitive function. Result： There were 64 cases cerebral arteriosclerosis in study group,accounting for 40.5%. Parkinson with cerebral arteriosclerosis group MCA and BA PI,RI were significantly higher than that of Parkinson without cerebral artery atherosclerosis group and the control group,Vm,Vd were significantly lower than Parkinson without cerebral artery atherosclerosis group and the control group（ P〈0.05）.Parkinson,Parkinson with cerebral arteriosclerosis group without cerebral arteriosclerosis group Mo CA each score and total score was significantly lower than the control group,the Parkinson with cerebral arteriosclerosis group Mo CA each score and total score were significantly lower than those of Parkinson without cerebral artery atherosclerosis group（ P〈0.05）. Correlation analysis showed that Mo CA score and cerebral basilar artery（ BA）,middle cerebral artery（ MCA） pulsatility index（ PI）,resistance index（ RI） showed a negative correlation（ r =-0.354,-0.276,-0.307,-0.235,P〈0.05）. Conclusion： There is a close relationship between the cognitive dysfunction and Parkinson disease patients with cerebral arteriosclerosis,as assessed by TCD in patients with cerebral arteriosclerosis of primary cognitive impairment in Parkinson＇s disease diagnosis has the certain value.