扩大的血管周围间隙与血管性痴呆的关系

Relationship Between Enlarged Perivascular Spaces and Vascular Dementia

目的:探讨扩大的血管周围间隙(enlarged perivascular spaces,EPVS)与血管性痴呆(vascular dementia,VD)之间的关系。方法:计数VD患者与正常对照组头颅磁共振(magnetic resonance imaging,MRI)不同部位EPVS数目,对EPVS与VD的相关性进行统计学分析,评估EPVS与VD之间的相关性。结果:90例VD患者中EPVS个数551个,EPVS更多分布于基底节区(232个)、大脑半球(140个)及脑干(79个);正常对照组90例中EPVS个数59个(基底节区14个、大脑半球11个及脑干9个)。EPVS分级以1分最多见。EPVS分级越高,蒙特利尔认知评估量表(montreal cognitive assessment,Mo CA)分值越低(P<0.05)。不同部位EPVS与Mo CA分值之间的关系,差异均有统计学意义(P<0.05)。皮层下EPVS数目较多的Mo CA分值更低,导致患者出现更严重的认知功能下降。结论:EPVS与VD密切相关,提示EPVS是血管性痴呆的重要标志之一。

Objective：To explore the correlation between enlarged perivascular spaces（EPVS） and vascular dementia（VD）.Method：The EPVS numbers in the different positions of the head of VD patients and the normal control group were counted based on the magnetic resonance imaging（MRI）,and the statistic analysis was carried out to evaluate the correlation between EPVS and VD.Result：In 90 VD patients,the total number of EPVS was 551.The EPVS mainly occurred in basal ganglia region（n=232）,cerebral hemispheres（n=140） and brainstem（n=79）.The number of EPVS was 59（14 in the basal ganglia region,11 in cerebral hemispheres and 9 in brainstem,et al）.Rank 1 was the most common in EPVS rating.The higher ranking of EPVS,the lower score of MOCA（P〈0.05）.The variation of the relationship between EPVS of different positions and MOCA score,there was statistically significant（P〈0.05）.The more subcortical EPVS resulted in the lower MOCA score,the severer cognitive decline.Conclusion：EPVS correlates closely with VD,meaning that EPVS is one of the important indicator of VD.