急性缺血性卒中患者认知功能与血管周围间隙扩大的相关性

The relationship between cognitive function and the enlargement of peripheral vascular space in patients with acute ischemic stroke

目的探讨急性缺血性卒中(acute ischemic stroke,AIS)患者血管周围间隙扩大(enlarged perivascular space,EPVS)与认知功能的关系。方法选取2016年9月至2018年12月于本院神经内科住院并且完成认知功能检测的首发AIS患者223例,依据MoCA评分结果,将所有患者分为认知障碍组(n=67)及认知正常组(n=156)。应用SPSS 21.0统计软件分析影响患者认知功能的危险因素及血管周围间隙扩大与认知功能的关系。结果认知正常组、认知障碍组两组在年龄、冠心病病史、同型半胱氨酸水平、纤维蛋白原水平、基底节区(basal ganglia,BG)和半卵圆中心(centrum semiovale,CSO)的EPVS差异有统计学意义(均P<0.05)。年龄(B=0.067,OR=1.070,95%CI=1.035~1.106,P<0.05)、同型半胱氨酸水平(B=0.032,OR=1.033,95%CI=1.007~1.060,P=0.013)、BG-EPVS(B=0.720,OR=2.055,95%CI=1.041~4.055,P=0.038)可能是认知障碍的独立危险因素。认知障碍组BG-EPVS的程度与患者MoCA总分(r=-0.332,P<0.05)、视空间与执行(r=-0.256,P<0.01)、注意力(r=-0.256,P<0.01)、语言(r=-0.182,P<0.05)、定向(r=-0.370,P<0.05)呈负相关。结论EPVS,尤其是BG-EPVS可以作为评价AIS患者早期认知功能的指标。

Objective To investigate the relationship between the enlarged of peripheral vascular space and cognitive function in patients with acute ischemic stroke.Methods Totally 223 patients with first-episode acute cerebral infarction were selected from the department of neurology in Hebei general hospital from September 2016 to December 2018,who completed the test of cognitive function.All patients were divided into cognitive impairment group(n=67)and normal cognitive group(n=156)according to the score of MoCA.The risk factors of cognitive function and the relationship between the enlargement of perivascular space and cognitive function were analyzed by SPSS 21.0.Results Age,history of coronary heart disease,Hcy,Fib,BG-EPVS and CSO-EPVS were statistically significant different in cognitive impairment group and normal cognitive group(all P<0.05).Age(B=0.067,OR=1.070,95%CI=1.035-1.106,P<0.05),Hcy(B=0.032,OR=1.033,95%CI=1.007-1.060,P=0.013),and BG-EPVS(B=0.720,OR=2.055,95%CI=1.041-4.055,P=0.038)were independent risk factors for cognitive impairment.The degree of BG-EPVS in the cognitive impairment group was negatively correlated with the total MoCA score(r=-0.332,P<0.05),visual space and execution(r=-0.256,P<0.01),attention(r=-0.256,P<0.01),language(r=-0.182,P<0.05)and orientation(r=-0.370,P<0.05).Conclusion EPVS,especially BG-EPVS,can be used as an indicator to evaluate the early cognitive function of AIS patients.