脑动脉粥样硬化患者沟宽与脑回厚度在预测血管性认知功能障碍作用研究

Value of sulcus width and gyrus thickness in predicting vascular cognitive impairment in cerebral atherosclerosis patients

目的探讨脑动脉粥样硬化患者沟宽与脑回厚度在预测血管性认知功能障碍(VCI)的价值。方法选取120例脑动脉粥样硬化患者,根据是否患有VCI分成VCI组48例和非VCI组72例,收集2组一般临床资料,用头颅MRI检查,并计算左侧颞上回厚度和左侧胼胝体沟宽度,用Spearman相关分析左侧颞上回厚度、左侧胼胝体沟宽度与蒙特利尔认知评估量表(MoCA)评分相关性,采用logistic多因素回归分析影响因素。结果VCI组年龄、高血压比例及左侧胼胝体沟宽度明显高于非VCI组(P<0.01),MoCA评分和左侧颞上回厚度明显低于非VCI组[(20.3±2.3)分vs(26.8±3.4)分,P=0.000;(1.6±0.3)mm vs(1.9±0.4)mm,P=0.000]。Spearman相关性分析显示,左侧颞上回厚度与MoCA评分呈正相关(r=0.273,P=0.031),左侧胼胝体沟宽度与MoCA评分呈负相关(r=-0.323,P=0.027)。年龄、受教育年限、左侧颞上回厚度以及左侧胼胝体沟宽度与脑动脉粥样硬化患者VCI相关(P<0.05,P<0.01)。结论脑动脉粥样硬化合并VCI患者的左侧颞上回厚度以及左侧胼胝体沟宽度发生改变,左侧颞上回厚度以及左侧胼胝体沟宽度可能作为脑动脉粥样硬化患者发生VCI的预测指标。

Objective To study the value of sulcus width and gyrus thickness in predicting VCI in cerebral atherosclerosis patients.Methods One hundred and twenty cerebral atherosclerosis patients admitted to our hospital were divided into VCI group(n=48)and VCI-free group(n=72).Their general clinical data were recorded,their left superior temporal gyrus thickness and left corpus callosum sulcus width were measured by brain MRI.The relationship of left superior temporal gyrus thickness and left corpus callosum sulcus width with MoCA scale score was analyzed by Spearman correlation analysis.Results The age was significantly older,the incidence of hypertension was significantly higher and the left corpus callosum sulcus width was significantly longer(P<0.01)while the MoCA scale score was significantly lower and the left superior temporal gyrus thickness was significantly shorter in VCI group than in VCI-free group(20.3±2.3 vs 26.8±3.4,P=0.000;1.6±0.3 mm vs 1.9±0.4 mm,P=0.000).Spearman correlation analysis showed that the left superior temporal gyrus thickness was positively related with the MoCA scale score while the left corpus callosum sulcus width was negatively related with the MoCA scale score(P<0.05).Age,education time,left superior temporal gyrus thickness and left corpus callosum sulcus width were related with cerebral atherosclerosis in VCI patients(P<0.05,P<0.01).Conclusion Left superior temporal gyrus thickness and left corpus callosum sulcus width can be used as the predictors of VCI in cerebral atherosclerosis patients.