高血压脑小血管病患者抑郁与影像学标志物及认知功能相关性

The correlation of depression with imaging markers and cognitive function in patients with hypertensive-cerebral small vessel disease

目的探讨高血压脑小血管病(HT-CSVD)患者抑郁与影像学标志物及总负荷的关系,并分析抑郁与认知功能的相关性。方法纳入2023年5~12月保定市第一中心医院收治的141例HT-CSVD患者,依据汉密尔顿抑郁量表将患者分为抑郁组(n=49)与非抑郁组(n=92)。收集患者人口学信息、既往病史、MRI图像、实验室检查及认知功能评分等临床资料,分析HT-CSVD患者抑郁的危险因素以及抑郁与认知功能的关系。结果抑郁组患者腔隙、基底节区扩大的血管周围间隙(BG-EPVS)、CSVD影像学总负荷高于非抑郁组,白蛋白水平低于非抑郁组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示腔隙、BG-EPVS是HT-CSVD患者抑郁的独立危险因素(P<0.05)。HT-CSVD患者抑郁与认知功能的关系分析结果显示,抑郁组MoCA总评分与视空间与执行功能、命名、注意力、语言、延迟回忆和定向力等认知领域的单项评分均低于非抑郁组,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,抑郁评分与MoCA评分、视空间与执行功能、命名、注意力、语言、延迟回忆、定向力呈负相关(P<0.05)。结论腔隙、BG-EPVS是HT-CSVD患者抑郁的独立危险因素。HT-CSVD患者抑郁与认知功能关系密切。HT-CSVD患者抑郁与总体认知功能、视空间与执行功能、命名、注意力、语言、延迟回忆、定向力功能下降相关。

Objective To explore the relationship between depression and imaging markers as well as total burden in patients with hypertensive-cerebral small vessel disease(HT-CSVD),and analyze the correlation between depression and cognitive function.Methods A total of 141 patients with HT-CSVD admitted to Baoding No.1 Central Hospital from May to December 2023 were divided into depression group(n=49)and non-depression group(n=92)based on the Hamilton depression scale.Demographic information,past medical history,MRI images,laboratory tests and cognitive function scores were collected to analyze the risk factors of depression and the relationship between depression and cognitive function in HT-CSVD patients.Results Lacune,basal ganglia enlarged perivascular space(BG-EPVS),and the total burden of CSVD imaging of the patients in the depression group was higher than that of the non-depression group,and albumin levels were lower in the depression group,and the difference was statistically significant(P<0.05).Multifactorial Logistic regression analysis showed that lacune and BG-EPVS were independent risk factors for depression in HT-CSVD patients.The results of the analysis of the relationship between depression and cognitive function in HT-CSVD patients revealed that the total MoCA score and the individual scores of the cognitive domains such as visual-spatial and executive functions,naming,attention,language,delayed recall,and orientation were lower in the depression group compared to the non-depression group,with statistically significant differences(P<0.05).Spearman's correlation analyses showed a negative correlation between depression scores and MoCA scores,as well as visual-spatial and executive functions,naming,attention,language,delayed recall and orientation(P<0.05).Conclusion Lacune and BG-EPVS are independent risk factors for depression in HT-CSVD patients.Depression in HT-CSVD patients is closely related to cognitive function.Depression in HT-CSVD patients is associated with decreased overall cognitive function,visual space and executive function,naming,attention,language,delayed recall and orientation.