CAJ | 학술논문

目的：探讨代谢综合征（Mets）对皮质下缺血性血管病（SIVD）认知功能的影响。方法选择226例SIVD患者，其中Mets患者104例，代谢综合征倾向（R-Mets）68例，非代谢综合征（No-Mets）54例。 Mets的诊断标准采用NCEP-ATP Ⅲ标准；应用简易智能精神状态量表（ MMSE）、剑桥老年认知量表中文版（ CAMCOG-C）对SIVD患者的认知功能进行评定；采用Blen-now量表，按照脑损害程度分为4个亚型（Ⅰ～Ⅳ型，0～3分）。结果 Mets组和R-Mets组MMSE、CAMCOG-C均显著低于No-Mets组（均P＜0．05）；Mets组CAMCOG-C显著低于R-Mets（P＜0．05）。腰围、空腹血糖（IGT）、收缩压（SBP）、舒张压（DBP）、甘油三酯（TG）与SIVD患者总体认知得分呈显著负相关（均P＜0．05）；HDL-C与MMSE、CAMCOG-C得分呈显著正相关（均P＜0．05）。 No-Mets组中Ⅰ、Ⅱ型所占比例较高，分别为51．6％、27．8％，R-Mets组和Mets合并组中Ⅲ、Ⅳ型所占比例较高，分别为36％、30．8％，No-Mets组与R-Mets组和Mets合并组Ⅰ、Ⅱ、Ⅲ、Ⅳ各亚型发生率比较均有统计学意义（均P＜0．05）。结论 Mets及其各因子加重SIVD认知损害，其中腹型肥胖、IGT、SBP、DBP、TG、HDL-C是其重要危险因素；随着R-Mets、Mets发生率增高，SIVD脑损害愈加明显。
목적：탐토대사종합정（Mets）대피질하결혈성혈관병（SIVD）인지공능적영향。방법선택226례SIVD환자，기중Mets환자104례，대사종합정경향（R-Mets）68례，비대사종합정（No-Mets）54례。 Mets적진단표준채용NCEP-ATP Ⅲ표준；응용간역지능정신상태량표（ MMSE）、검교노년인지량표중문판（ CAMCOG-C）대SIVD환자적인지공능진행평정；채용Blen-now량표，안조뇌손해정도분위4개아형（Ⅰ～Ⅳ형，0～3분）。결과 Mets조화R-Mets조MMSE、CAMCOG-C균현저저우No-Mets조（균P＜0．05）；Mets조CAMCOG-C현저저우R-Mets（P＜0．05）。요위、공복혈당（IGT）、수축압（SBP）、서장압（DBP）、감유삼지（TG）여SIVD환자총체인지득분정현저부상관（균P＜0．05）；HDL-C여MMSE、CAMCOG-C득분정현저정상관（균P＜0．05）。 No-Mets조중Ⅰ、Ⅱ형소점비례교고，분별위51．6％、27．8％，R-Mets조화Mets합병조중Ⅲ、Ⅳ형소점비례교고，분별위36％、30．8％，No-Mets조여R-Mets조화Mets합병조Ⅰ、Ⅱ、Ⅲ、Ⅳ각아형발생솔비교균유통계학의의（균P＜0．05）。결론 Mets급기각인자가중SIVD인지손해，기중복형비반、IGT、SBP、DBP、TG、HDL-C시기중요위험인소；수착R-Mets、Mets발생솔증고，SIVD뇌손해유가명현。
Objective To explore the relationship between metabolic syndrome and the cognitive function of subcortical ischemic vascu -lar disease.Methods Two hundred and twenty-six patients with subcortical ischemic vascular disease (SIVD),including 104 Metabol-ic syndrome(Mets),68 Risk Metabolic syndrome(R-Mets),54 No Metabolic syndrome(NO-Mets),were selected.The diagnostic crite-ria of Mets were the standards of National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III).Cognitive function was assessed by the mini-mental state examination ( MMSE) and CAMCOG-C.MRI was evaluated by the Blennow scale ,which was di-vided into four subtypes by brain lesions .Results Both Mets group and R-Mets group showed significantly lower MMSE ,CAMCOG-C scores than No-Mets group(P<0.05).The CAMCOG-C scores in Mets group were lower than R-Mets group(P<0.05).The correla-tion between waistline,IGT,DBP,SBP,TG and total cognitive scores were significantly negative (P<0.05).There were positive corre-lation between HDL and MMSE,CAMCOG-C scores(P<0.05).The ratio of Ⅰ,Ⅱ subtypes in No-Mets group was much higher, 51.6%,and 27.8%respectively,while the ratio of Ⅲ,Ⅳsubtypes in R-Mets and Mets group was much higher ,36.0%,and 30.8%respectively .Morbidities of the four subtypes were significantly different between No-Mets group and R-Mets and Mets group ( P <0.05).Conclusions Mets and its individual components can aggravate the cognitive impariment of SIVD ,of which abdominal obesity, IGT,SBP,DBP,TG,HDL-C are the important risk factors .With morbidity increase of R-Mets and Mets ,the brain lesions of SIVD become severer .