脑血流动力学指标变化与脑血管老化关系

Relationship between changes of cerebrovascular hemodynamic indexes and cerebrovascular aging

目的探讨脑血流动力学指标的年龄变化规律与血管老化的关系。方法选择2014年1—10月在中南大学湘雅第三医院、中国人民解放军180医院、山东电力中心医院、南华大学附属第二医院4个健康管理中心参加健康体检的人群作为研究对象,调查年龄、性别等一般情况,进行无创伤脑血流动力学检查。按年龄、性别分组,比较不同年龄组间脑血管功能积分值、平均流速、最小流速、脉搏波波速、外周阻力等指标的差异及变化规律。结果纳入研究对象共计29 931人,年龄范围20~94岁。男女脑血管功能积分值异常率(<75分)分别为23.4%和21.2%,平均值分别为(82.18±23.65)和(84.33±22.05)分,差异均有统计学意义(P<0.05)。随着年龄的增长,脑血管功能积分值、平均脑血流速度、最小脑血流速度呈明显的降低趋势,脉搏波波速、外周阻力呈明显的上升趋势,上述指标年龄组间的差异均有统计学意义(P<0.05)。45岁和65岁年龄组是脑血管功能积分值降低幅度加大的拐点,>65岁各年龄组脑血管功能积分值持续大幅度降低。结论脑血流动力学指标的异常变化与增龄密切相关,步入中年和老年,脑血管功能下降的幅度加大,>65岁脑血管功能持续大幅下降。

Objective To study the relationship between age-related changes of cerebrovascular hemodynamic inde- xes （CVHIs） and cerebrovascular aging. Methods We recruited adult physical examinees （ ≥20 years old） at 4 health care management centers of 4 general hospitals in 4 cities between January and October 2014. Demographic and other rel- evant information of the participants were collected and non-invasive detection of CVHIs were conducted among the par- ticipants. Gender- and age-specific variations in CVHI integral score, mean velocity （Vmean）, minimum velocity （Vmin） , pulse wave velocity （WV） , and peripheral vascular resistance （Rv）were analyzed and compared. Results To- tally 29 93 l participants aged 20 - 94 years were included in the study. The abnormality rate of integral score （ 75 ） and mean score of CVHI were 23.4% and 82. 18 ± 23.65 for the male participants and 21.2% and 84. 33 ± 22. 05 for the fe- male participants,with significant differences （ both P 〈 0. 05 ）. Significant decreasing trends of CVHI integral score, Vmean, and Vmin and increasing trends of WV and Rv were observed with the increment of age among the participants （P 〈0. 05 for all）. There were significant between age group differences in all the CVHIs. The ages of 45 and 65 years were the two turning points for substantial decrease of CVHI integral score and the CVHI integral score decreases drasti- cally and persistently among the participants more than 65 years old. Conclusion Abnormal changes in CVHI associated closely with the increment of age;cerebrovascular function declines obviously among the middle-aged and the elderly and the decline are dramatic and persistent among the people more than 65 years old.