不同合并类型的脑小血管病与血管性认知功能障碍的相关性研究

Correlation between different concomitant types of cerebral small vessel disease and vascular cognitive dysfunction

目的:探讨不同合并类型的脑小血管病与血管性认知功能障碍的相关性。方法:选择门诊、住院的脑小血管病病人96例为观察组,经认知功能测定及影像学检查均无异常的正常人90例为对照组。研究对象入组后均采用GE Signa 3.0T EXCITE HDMR系统进行头颅MRI平扫+DWI+SWI+MRA检查,由2个副主任医师级别的磁共振专科医生进行读片,按照头颅MRI检查结果,将研究对象分为单一类型脑小血管病组、合并2种类型脑小血管病组、合并3种类型脑小血管病组、合并4种类型脑小血管病组及正常对照组。并对研究对象采用采用蒙特尔认知评估量表(MoCA)、简易精神状态评价量表(MMSE)进行认知功能评定。比较不同研究对象MoCA及MMSE水平,并对脑小血管病复杂程度与MoCA、MMSE进行相关性分析。结果:观察组病人MoCA及MMSE水平均明显低于对照组(P<0.01)。不同类型脑小血管病病人MoCA及MMSE得分差异均有统计学意义(P<0.01),MoCA及MMSE得分依次为单一脑小血管病组>合并2种类型脑小血管病组>合并3种类型脑小血管病组>合并4种类型脑小血管病组(P<0.05)。相关性分析结果显示脑小血管病复杂程度与MoCA、MMSE均呈负相关关系(P<0.01)。结论:脑小血管病病人血管性认知功能障碍的发生明显高于健康人群,且随脑小血管病复杂程度升高而更严重。

Objective:To investigate the correlation between different concomitant types of cerebral small vessel disease and vascular cognitive dysfunction.Methods:A total of 96 outpatients and inpatients with cerebrovascular disease were selected as the observation group,while 90 normal subjects with normal cognitive function and imaging examination were selected as the control group.After enrollment,all subjects were subjected to GE Signa 3.0T EXCITE HDMR system for head MRI scan+DWI+SWI+MRA,and the films were read by two MRI specialists at the associate chief physician level.According to the results of the head MRI,the subjects were divided into single type of cerebral small vessel disease group,two types of cerebral small vessel disease group,three types of cerebral small vessel disease group,four types of cerebral small vessel disease group and normal control group.Neurological evaluation was performed on the patients using the Montrel cognitive assessment(MoCA)and the mini mental state examination(MMSE).The levels of MoCA and MMSE in different subjects were compared,and the correlation between the complexity of cerebral small vessel disease and MoCA and MMSE was analyzed.Results:The levels of MoCA and MMSE in the observation group were significantly lower than those in the control group(P<0.01).The differences of MoCA and MMSE scores in patients with different types of cerebral small vessel disease were statistically significant(P<0.01).The scores of MoCA and MMSE were as follows:single cerebral small vessel disease group>two types of cerebral small vessel disease group>three types of cerebral small vessel disease group>four types of cerebral small vessel disease group(P<0.05).Correlation analysis showed that the complexity of cerebral small vessel disease was negatively correlated with MoCA and MMSE(P<0.01).Conclusions:The vascular cognitive dysfunction in patients with cerebral small blood vessel disease is significantly higher than that in healthy people,and the vascular cognitive impairment is more serious with the complexity of cerebral small vessel disease.