缺血性脑白质病变患者脑血管储备功能的研究

Cerebrovascular reserve capacity of patients with ischemic cerebral white matter lesions

目的:探讨缺血性脑白质病变(WML)患者脑血管储备功能(CVR)的变化。方法:126例住院的脑血管病患者根据颅脑MRI分为正常组及轻、中、重度WML组。对所有受试者均测量血压、血糖、血脂并详细记录既往史。应用经颅多普勒超声和CO2分压检测仪,通过吸入自身CO2气体诱导高碳酸血症、过度换气诱导低碳酸血症的方法测定CVR。结果:年龄、高血压、糖尿病史、血压、血糖、Apo-A为WML的独立危险因素。中、重度WML组患者CVR明显低于正常组(P<0.05);WML病变的程度与CVR呈负相关(低、高碳酸血症分别为rs=-0.273、-0.392,P=0.021、0.008)。结论 :年龄、高血压、糖尿病、Apo-A为WML的独立危险因素。WML患者CVR明显降低。

Objective To investigate the changes of cerebrovascular reserve capacity （CVR） in patients with ischemic white matter lesions （WML）. Methods 126 patients with WML were divided into mild lesion, moderate lesion, severe WML groups and a normal control group by brain MRI. Blood pressure, blood sugar, blood fat were measured and past medical histories were recorded in details. All the patients were routinely examined using TCD to evaluate CVR. Hypercapnia was induced by inhaling the CO2 they breathed themselves and hypocapnia was done by voluntary hyperventilation. Results Age, hypertension, diabetes mellitus and Apo-A were the independent risk factors for WML. Compared with the controls, CVR decreased significantly in the severe and moderate WML groups （P 〈 0.05）. The extent of WML negatively correlated to the cerebrovascular reserve capacity （rs = -0.273, -0.392）. Conclusions Age, hypertension, diabetes mellitus and Apo-A are the independent risk factors for WML. CVR is significantly decreased in the WML.