脑小血管病患者的脑小血管病MRI总体负担与空间导航功能受损的相关性

Correlation between global burden of small vessel disease on MRI and impaired spatial navigation in patients with cerebral small vessel disease

目的探讨脑小血管病(cerebral small vessel disease,CSVD)患者MRI总体负担与空间导航功能的相关性。方法以2020年11月至2022年6月在南京市江宁医院神经内科住院治疗的CSVD患者作为研究对象。根据患者头颅MRI结果进行CSVD总体负担评分,并分为轻度组(0~1分)、中度组(2分)和重度组(3~4分)。对所有患者进行空间导航功能测试。采用多元线性回归模型分析CSVD总体负担与空间导航功能的相关性。结果共纳入101例CSVD患者,其中轻度组37例(36.6%),中度组28例(27.7%),重度组36例(35.6%)。中度组和重度组年龄、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇和肌酐以及高血压、糖尿病、既往卒中或短暂性脑缺血发作史患者构成比均显著高于轻度组,而高密度脂蛋白胆固醇显著低于轻度组(P均<0.05)。空间导航功能测试表明,与轻度组相比,中度组和重度组环境+自我导航、自我导航以及环境导航功能均显著下降(P均<0.05)。多元线性回归分析显示,在校正年龄、性别、高血压、既往卒中或短暂性脑缺血发作史和受教育年限后,CSVD总体负担与环境+自我导航(β=0.518,P<0.001)、自我导航(β=0.481,P<0.001)、环境导航(β=0.699,P<0.001)功能均存在显著相关性。结论CSVD总体负担与空间导航功能存在相关性。

Objective To investigate the correlation between global burden of small vessel disease(CSVD)on MRI and impaired spatial navigation in patients with CSVD.Methods Patients with CSVD admitted to the Department of Neurology,Nanjing Jiangning Hospital from November 2020 to June 2022 were selected as the research subjects.The global burden of CSVD was scored according to the head MRI findings,and was divided into mild group(0-1 points),moderate group(2 points),and severe group(3-4 points).All patients were tested for spatial navigation function.Multivariate linear regression model was used to analyze the correlation between the global burden of CSVD and the spatial navigation function.Results A total of 101 patients with CSVD were enrolled,including 37 patients in the mild group(36.6%),28 in the moderate group(27.7%),and 36 in the severe group(35.6%).Age,glycosylated hemoglobin,total cholesterol,low-density lipoprotein cholesterol and creatinine,as well as the proportions of hypertension,diabetes,previous stroke or transient ischemic attack in the moderate group and the severe group were significantly higher than those in the mild group,while the high-density lipoprotein cholesterol was significantly lower than that in the mild group(all P<0.05).The spatial navigation function test showed that the environment+self-navigation,self-navigation and environment navigation functions of the moderate group and the severe group decreased significantly compared with the mild group(all P<0.05).Multivariate linear regression analysis showed that after adjusting for age,sex,hypertension,previous stroke or transient ischemic attack history and years of education,the global burden of CSVD and environment+self-navigation(β=0.518,P<0.001),self-navigation(β=0.481,P<0.001)and environmental navigation(β=0.699,P<0.001)function had significant correlation.Conclusion The global burden of CSVD is correlated with spatial navigation functions.