老年女性精神压力与脑血管储备功能的相关性分析

Correlation analysis of mental stress and cerebrovascular reserve capacity in the elderly women

目的探讨老年女性精神压力与脑血管储备功能(CVR)的相关性。方法选择2012年6月至2013年9月山东省济南地区年龄≥60岁的女性465例,根据老年抑郁量表(GDS)和老年焦虑量表(GAI)的评分将受试者分为无焦虑与抑郁症状组275例和有焦虑或抑郁症状组190例,受试者在基线及随访结束时均进行经颅多普勒超声检查并计算CVR、屏气指数(BHI)、大脑中动脉搏动指数(PI)以及阻力指数(RI)。结果两组CVR、BHI、PI和RI的变化率之间的差异有统计学意义(t=6.797、22.007、-28.315、-8.551,P<0.05);GAI和GDS评分分别与PI变化率(r=0.549、0.494,P<0.01)及RI变化率(r=0.239、0.292,P<0.01)呈正相关;与BHI变化率(r=-0.457、-0.411,P<0.01)及CVR变化率(r=-0.399、-0.349,P<0.01)呈负相关;校正混杂因素后,GDS评分和GAI评分是CVR、BHI、PI及PRI变化率的影响因素(β=-0.386、-0.226、-0.378、-0.245、0.322、0.198、0.115、0.128,P<0.01)。结论老年女性精神性压力与CVR相关,焦虑抑郁是CVR的影响因素。

Objective To explore the correlation between mental stress and cerebrovascular reserve capacity(CVR)in elderly women.Methods A total of 465 women aged≥60 years in Jinan region,Shandong Province from June 2012 to September 2013 were selected and divided into the group without anxiety or depressive symptoms(275 cases)and the group with anxiety or depressive symptoms(190 cases)according to the scores of Geriatric Depression Scale(GDS)and Geriatric Anxiety Inventory(GAI).The subjects underwent transcranial Doppler ultrasound examination,and the CVR,breath-hold index(BHI),pulsatility index(PI)of the middle cerebral artery,and resistance index(RI)at both baseline and the last follow-up were calculated.Results There were statistically significant differences in the change rates of CVR,BHI,PI and RI between the two groups(t=6.797,22.007,-28.315,-8.551;P<0.05).GAI and GDS scores were positively correlated with the change rates of PI(r=0.549,0.494;P<0.01)and RI(r=0.239,0.292;P<0.01),and negatively correlated with the change rates of BHI(r=-0.457,-0.411;P<0.01)and CVR(r=-0.399,-0.349;P<0.01).After adjusting for confounding factors,GDS and GAI scores were found to be the influencing factors for the change rates of CVR,BHI,PI and PRI(β=-0.386,-0.226,-0.378,-0.245,0.322,0.198,0.115,0.128;P<0.01).Conclusion Mental stress is related to CVR in elderly women,and anxiety and depression are influencing factors for CVR.