东南大学学报（医学版）
東南大學學報（醫學版）
동남대학학보（의학판）
JOURNAL OF SOUTHEAST UNIVERSITY(MEDICAL SCIENCE EDITION)
2013年
6期
738-742
,共5页
曹月洲%陈伟贤%王峥%张赛%钱云%程曦%曾彦英
曹月洲%陳偉賢%王崢%張賽%錢雲%程晞%曾彥英
조월주%진위현%왕쟁%장새%전운%정희%증언영
脑小血管病%认知障碍%白质病变%腔隙性脑梗死%相关性
腦小血管病%認知障礙%白質病變%腔隙性腦梗死%相關性
뇌소혈관병%인지장애%백질병변%강극성뇌경사%상관성
cerebral small vessel disease%cognitive impairment%white matter lesions%lacunar infarction%relationship
目的：探讨脑小血管病（CSVD）MRI表现与认知障碍（CI）的关系。方法：分析93例符合CSVD患者MRI表现的白质病变（WML）及腔隙性脑梗死（LI）的病灶和数量，根据蒙特利尔认知评估（MoCA）量表将患者分为认知障碍（CI）组和非认知障碍（no CI，NCI）组，分析两组患者MRI表现与CI的关系。结果：两组患者动脉硬化危险因素相比，在饮酒、高血压和血脂方面， CI组的发生率显著高于NCI组（分别是71.4％ vs 27.5％，57.1％vs 27.5％，54.8％vs 17.6％；分别P＝0.00、0.004和0.00），而在吸烟和糖尿病方面，两组差异无统计学意义（分别50.0％vs 25.5％，21.4％vs 11.6％；分别P＝0.15和0.207）；CI组LI病灶总数和脑WML分值明显高于NCI组，差异具有统计学意义（ P＜0.01）。在校正年龄、性别和WML的影响后，LI病灶总数能解释MoCA得分的55.1％。同时MoCA分值仍与WML有关（ P＜0.001），说明LI病灶总数和WML均为MoCA分值的预测因素，而LI部位能解释MoCA得分的42.9％（ P＜0.001）。其中额区、颞区和基底核区LI数量与MoCA分值呈正相关（ P＜0.01），顶枕区和幕下区LI数量与MoCA分值无相关性（ P＞0.05）。结论：WML以及LI病灶的数量和部位均与CSVD患者的CI有关，额区、颞区和基底核区LI病灶数量与CI的严重度呈正相关。
目的：探討腦小血管病（CSVD）MRI錶現與認知障礙（CI）的關繫。方法：分析93例符閤CSVD患者MRI錶現的白質病變（WML）及腔隙性腦梗死（LI）的病竈和數量，根據矇特利爾認知評估（MoCA）量錶將患者分為認知障礙（CI）組和非認知障礙（no CI，NCI）組，分析兩組患者MRI錶現與CI的關繫。結果：兩組患者動脈硬化危險因素相比，在飲酒、高血壓和血脂方麵， CI組的髮生率顯著高于NCI組（分彆是71.4％ vs 27.5％，57.1％vs 27.5％，54.8％vs 17.6％；分彆P＝0.00、0.004和0.00），而在吸煙和糖尿病方麵，兩組差異無統計學意義（分彆50.0％vs 25.5％，21.4％vs 11.6％；分彆P＝0.15和0.207）；CI組LI病竈總數和腦WML分值明顯高于NCI組，差異具有統計學意義（ P＜0.01）。在校正年齡、性彆和WML的影響後，LI病竈總數能解釋MoCA得分的55.1％。同時MoCA分值仍與WML有關（ P＜0.001），說明LI病竈總數和WML均為MoCA分值的預測因素，而LI部位能解釋MoCA得分的42.9％（ P＜0.001）。其中額區、顳區和基底覈區LI數量與MoCA分值呈正相關（ P＜0.01），頂枕區和幕下區LI數量與MoCA分值無相關性（ P＞0.05）。結論：WML以及LI病竈的數量和部位均與CSVD患者的CI有關，額區、顳區和基底覈區LI病竈數量與CI的嚴重度呈正相關。
목적：탐토뇌소혈관병（CSVD）MRI표현여인지장애（CI）적관계。방법：분석93례부합CSVD환자MRI표현적백질병변（WML）급강극성뇌경사（LI）적병조화수량，근거몽특리이인지평고（MoCA）량표장환자분위인지장애（CI）조화비인지장애（no CI，NCI）조，분석량조환자MRI표현여CI적관계。결과：량조환자동맥경화위험인소상비，재음주、고혈압화혈지방면， CI조적발생솔현저고우NCI조（분별시71.4％ vs 27.5％，57.1％vs 27.5％，54.8％vs 17.6％；분별P＝0.00、0.004화0.00），이재흡연화당뇨병방면，량조차이무통계학의의（분별50.0％vs 25.5％，21.4％vs 11.6％；분별P＝0.15화0.207）；CI조LI병조총수화뇌WML분치명현고우NCI조，차이구유통계학의의（ P＜0.01）。재교정년령、성별화WML적영향후，LI병조총수능해석MoCA득분적55.1％。동시MoCA분치잉여WML유관（ P＜0.001），설명LI병조총수화WML균위MoCA분치적예측인소，이LI부위능해석MoCA득분적42.9％（ P＜0.001）。기중액구、섭구화기저핵구LI수량여MoCA분치정정상관（ P＜0.01），정침구화막하구LI수량여MoCA분치무상관성（ P＞0.05）。결론：WML이급LI병조적수량화부위균여CSVD환자적CI유관，액구、섭구화기저핵구LI병조수량여CI적엄중도정정상관。
Objective:To investigate the relationship between cerebral small vessel disease ( CSVD) assessed by magnetic resonance imaging and cognitive impairment .Methods:A total of 93 patients with CSVD , characterized by white matter lesions (WML) and lacunar infarction (LI) were divided into cognitive impairment (CI) and no cognitive impairment (NCI) groups according to Montreal Cognitive Assessment (MoCA).The severity of WML was assessed , and the total number of LI and the numbers of LI in different regions of the brain were recorded . Their correlation with CI was analyzed .Results: As compared with the NCI group , the proportion of alcohol , hypertension and blood TC and LDL-C concentration in CI group were significantly increased ( P<0.05 ); there were no significant differences in the proportion of smokers and diabetes mellitus between two groups ( P>0.05) . The total number of LI and the scores of WML were significantly increased in CI group than those in NCI group ( P<0.01) .After controlling the impact of age , sex and the scores of WML , the total number of LI could account for 55.1%of the scores of MoCA .LI numbers in frontal , temporal and basal ganglia area were positively correlated to MoCA scores ( P<0.01 ) , while those in parieto-occipital and infratentorial area were not correlated significantly ( P>0.05) .Conclusion:The WML and the numbers and locations of LI are related to CI symptoms .The numbers of LI at frontal , temperal and basal ganglia areas were independent prediction of CI in patients with CSVD .
