胆碱能通路损伤与脑卒中后认知障碍患者颅内动脉血流动力学的关系

Relationship between cholinergic pathway injury and intracranial arterial hemodynamics in patients with cognitive impairment after stroke

目的探究胆碱能通路(CP)损伤与脑卒中后认知障碍患者颅内动脉血流动力学的关系。方法选择2015.年7月-2019年7月廊坊广安医院收治的196例脑卒中患者为研究对象,根据其是否发生认知功能障碍分为认知功能正常组(n=88)和认知功能障碍组(n=108),比较两组患者大脑中动脉(MCA)的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、血管阻力指数(RI)、胆碱能通路高信号量表(CHIPS)评分,比较不同CHIPS评分的脑卒中后认知功能障碍患者颅内动脉血流参数,采用Pearson相关分析脑卒中后认知功能障碍患者CHIPS评分与颅内动脉血流参数的相关性。结果认知功能障碍组RI显著高于认知功能正常组(P<0.05),PSV、EDV显薯低子认知功能正常组(P<0.05),CHIPS评分显薯高子认知功能正常组(P<0.05)。CHIPS评分≥54分的脑卒中后认知功能障碍患者RI显著高于CHIPS评分<54分的脑卒中后认知功能障碍患者(P<0.05),PSV、EDV显著低于CHIPS评分<54分的脑卒中后认知功能障碍患者(P<0.05)。脑卒中后认知功能障碍患者CHIPS评分与RI呈正相关(P<0.05),与PSV、EDV呈负相关(P<0.05)。结论脑卒中后认知功能障碍患者存在明显脑血液循环障碍和胆碱能通路损伤,胆碱能通路损伤与患者脑血液循环障碍存在一定相关性,这可为防治脑卒中后认知功能障碍提供理论基础。

Objective To investigate the relationship between cholinergic pathway(CP)injury and intracranial arterial hemodynamics in patients with cognitive impairment after stroke.Methods A total of 196 stroke patients admitted to our hospital from July 2015 to July 2019 were selected,and divided into two groups according to the absence or presence of cognitive impaiment,normal cognitive function group(n=88)and the cognitive impairment group(n=108).The peak systolic velocity(PSV),end-diastolie velocity(EDV),vascular resistance index(RI)of the middle cerebral artery(MCA)and cholinergie pathways hy perintensities scale(CHIPS)scores in the two groups were compared.Intracranial arterial blood flow parameters of patients with cognitive impairment after stroke were compared among patients with different CHIPS scores.Then the correlation between CHIPS score and intracranial arterial blood flow parameters in patients with cognitive impairment after stroke was analyzed using Pearson correlation analysis.Results The RI of cognitive impairment group was significantly higher than that of normal cognitive function group(P<0.05);PSV and EDV of cognitive impaiment group were significantly lower than those of normal cognitive function group(P<0.05);the CHIPS score of cognitive impairment group was significant Higher than the normal cognitive function group(P<0.05);Within the cognitive impairment group,RI of patients with CHIPS score≥54 w as signifcanly higher than that of patients with CHIPS score<54(P<0.05);PSV and EDV of patients with CHIPS score≥54 were significantly lower than those of patients with CHIPS score<54(P<0.05).The CHIPS score of patients with cognitive impairment after stroke was positively correlated with RI(P<0.05),and was negatively correlated with PSV and EDV(P<0.05).Conclusion Patients with cognitive impairment after stroke have obvious cerebral blood circulation disorder and cholinergic pathway damage,moreover,the cholinergic pathway damage has certain orrelation with cerebral blood eireulation disorder,which can provide a theory basis for preventing and treating cognitive impairment after stroke.