脑白质疏松患者微出血与认知功能障碍的相关性研究

Study on the correlation between microbleeding and cognitive impairment in patients with leukoaraiosis

目的分析不同程度脑白质疏松(LA)患者发生脑微出血(CMBs)的差异,并评估CMBs与认知功能障碍的相关性。方法选取2017-01—2019-06南京医科大学康达学院附属连云港中医院脑病科、康复科收治的轻、中、重度LA患者各20例,均行磁共振常规序列及磁敏感加权成像(SWI)序列检查,分别统计不同程度LA患者的CMBs病灶数量;依据是否合并CMBs病灶,将LA患者分为CMBs组与非CMBs组,采用蒙特利尔认知评定量表(MoCA)分别对患者进行认知功能评估,分析CMBs病灶与认知功能障碍的相关性。结果轻度LA患者共检出CMRs病灶36个,中度LA患者共检出CMRs病灶137个,重度LA患者共检出CMRs病灶340个,检出部位以基底节区、皮层及皮层下区域最为多见;同时CMBs组患者MoCA评分低于非CMBs组(P<0.05)。结论CMBs病灶数目与LA程度呈正相关,且与患者认知功能障碍具有明显相关性,可作为LA程度、患者认知功能、临床预后及疗效的临床评价指标之一。

Objective To analyze the difference of cerebral microbleeding(CMBs)in patients with different degrees of leukoaraiosis(LA),and to evaluate the correlation between CMBs and cognitive impairment.Methods From January 2017 to June 2019,20 patients with mild,moderate and severe LA were selected from Encephalopathy Department and Rehabilitation Department of Lianyungang Hospital of Traditional Chinese Medicine Affiliated to Kangda College of Nanjing Medical University.Routine magnetic resonance sequence and magnetic susceptibility weighted imaging(SWI)sequence were used to examine the number of CMBs lesions in patients with different degrees of LA.The patients with CMBs lesions were divided into CMBs group and non-CMBs group.The cognitive function of patients was assessed by Montreal Cognitive Assessment Scale(MoCA),and the correlation between CMBs lesions and cognitive impairment was analyzed.Results 36 lesions of CMRs were detected in patients with mild LA,137 in patients with moderate LA and 340 in patients with severe LA.The most common locations were basal ganglia,cortex and subcortex.MoCA score in patients with CMBs was lower than that in non-CMBs group(P<0.05).Conclusion The number of lesions in CMBs is positively correlated with the degree of LA,and is also significantly correlated with cognitive impairment of patients.CMBs can be used as one of the clinical evaluation indicators of LA degree,cognitive function,clinical prognosis and curative effect.