急性前循环穿支动脉梗死的脑小血管病影像总负荷与认知功能损害的相关性研究

Correlation between Total Imaging Load and Cognitive Impairment in Cerebral Small Vessel Disease with Acute Anterior Circulation Penetrating Artery Infarction

目的分析急性前循环穿支动脉梗死的脑小血管病患者影像总负荷、认知功能损害程度二者间的相关性。方法选择2021年1月—2022年9月宜兴市人民医院神经内科收治的急性前循环穿支动脉梗死的100例脑小血管病患者作为研究对象,根据蒙特利尔认知量表(MoCA)评分结果将其患者分作CI组(认知功能损害患者,70例)与NCI组(认知功能未损害患者,30例),两组患者均接受影像学检测,同时用Fazekas量表评估患者脑实质中脑白质损伤的程度,进行脑小血管(CSVD)总负荷评分,对比组间差异性,同时探讨脑小血管病总负荷与认知功能损害情况的相关性。结果CI组患者MoCA认知功能评分(21.17±1.45)分明显低于NCI组,差异有统计学意义(t=24.529,P<0.05),同时CI组患者脑小血管病影像总负荷评分、深部白质高信号评分、脑室旁白质高信号评分均明显高于NCI组患者,差异有统计学意义(P<0.05)。相关性分析结果显示,脑小血管病影像总负荷、深部白质高信号、脑室旁白质高信号均与认知功能损害存在负相关(P<0.05)。结论急性前循环穿支动脉梗死患者的脑小血管病影像总负荷与认知功能损害存在密切相关性,而影像总负荷与白质病变有关,提示脑小血管的损伤是导致认知功能损害的可能机制之一。

Objective To analyze the correlation between the total imaging load and the degree of cognitive impairment in patients with cerebral small vessel disease with acute anterior circulation penetrating artery infarction.Methods One hundred patients with cerebral small vessel disease with acute anterior circulation penetrating artery infarction admitted to the Department of Neurology of Yixing People's Hospital for treatment from January 2021 to September 2022 were selected as study subjects.The patients were divided into CI group(patients with cognitive impairment,seventy cases)and patients with no cognitive impairment,thirty cases(NCI group)according to the MoCA(Montreal Cognitive Inventory)scores.Patients in both groups underwent imaging tests.The degree of white matter damage in the brain parenchyma of the patients was also assessed by the Fazekas scale,and the total cerebral small vessel(CSVD)load score was performed to compare the differences between the groups.The correlation between the total cerebral small vessel disease load and cognitive impairment was also investigated.Results The MoCA cognitive function score(21.17±1.45)points in the CI group was significantly lower than that in the NCI group,and the difference was statistically significant(t=24.529,P<0.05).At the same time,the total cerebral small vessel disease imaging load score,deep white matter high signal score,and periventricular white matter high signal score in the CI group were significantly higher than those in the NCI group,and the differences were statistically significant(P<0.05).The results of correlation analysis showed that the total image load,deep white matter high signal and periventricular white matter high signal of cerebral small vessel disease were negatively correlated with cognitive impairment(P<0.05).Conclusion The total imaging load of cerebral small vessel disease in patients with acute anterior circulation perforating artery infarction is closely related to cognitive impairment,and the total imaging load is related to white matter lesions,suggesting that the damage of cerebral blood vessels is one of the possible mechanisms leading to cognitive impairment.