脑血管储备功能在老年遗忘型轻度认知障碍中的应用价值

Application value of cerebrovascular reserve in elder patients with amnestic mild cognitive impairment

目的研究老年遗忘型轻度认知障碍(aMCI)患者脑血管储备(CVR)功能的特点。方法收集2012-4—2016-1就诊于首都医科大学附属复兴医院、年龄≥60岁、确诊为aMCI的患者40例,同时选择认知功能正常的健康者42名为正常对照组。所有受试者分别进行经颅多普勒超声(TCD)屏气试验及听觉事件相关电位(AERPs)检查,分析屏气指数(BHI)与认知功能及脑血流动力学的相关性。结果 aMCI组BHI较正常组下降(P<0.01);aMCI组BHI与蒙特利尔量表(Montreal cognitive assessment,MoCA)评分呈正相关(r=0.634,P<0.01),与P300潜伏期呈负相关(r=-0.426,P<0.01);aMCI组患者BHI与大脑中动脉(MCA)的搏动指数(PI)呈负相关(r=-0.365,P<0.05);aMCI患者PI异常者其BHI较PI正常者降低(P<0.05)。结论老年aMCI患者CVR功能下降,其认知功能受损与CVR减低有一定相关性。

Objective To study the characteristics of cerebrovascular reserve （CVR） in elder patients with amnestic mild cognitive impairment （aMCI） . Methods 82 subjects whose ages were over 60 years old from Fuxing Hospital affiliated to Capital Medical University were selected. These cases were divided into the aMCI group （40 cases） and the normal control （NC） group （42 cases） . The correlation analysis of breath‐holding index （BHI） ,cognitive function and cerebral hemodynamics were performed.Results Compared with the the NC group ,BHI significantly decreased in the aMCI group （P〈0.01） . The correlation analysis showed that BHI of the aMCI group was positively correlated with Montreal cognitive assessment （MoCA） score （r=0.634 ,P〈0.01） and had negative correlation with P300 latency （r= -0.426 ,P〈0.01） and pulsatility index （PI） of middle cerebral artery （MCA） （r= -0.365 , P〈0.05） . BHI of the patients with abnormal PI in the aMCI group was significantly lower than that in the normal PI group （P〈0.05） . Conclusions CVR in elder patients with aMCI is impaired. The decline of cognitive function was related to the decrease of CVR.