非痴呆型血管性认知功能障碍患者脑血流与MMSE及MoCA评分的相关性研究
비치태형혈관성인지공능장애환자뇌혈류여MMSE급MoCA평분적상관성연구
A Correlation Study between the Changes of Cerebral Blood Flow and MMSE and MoCA Scores in Vascular Cognitive Impairment with No Dementia
  • 万方数据
    中国临床神经科学 중국림상신경과학
    CHINESE JOURNAL OF CLINICAL NEUROSCIENCES
    2014年 4期 369-376 ,共8页

    王前友%王文安%沈亚雯%潘溢丹%赵燕燕%谢娟%施德

    왕전우%왕문안%침아문%반일단%조연연%사연%시덕

    认知功能%单光子发射计算机断层扫描%神经心理评分%非痴呆型血管性认知功能障碍 認知功能%單光子髮射計算機斷層掃描%神經心理評分%非癡呆型血管性認知功能障礙
    인지공능%단광자발사계산궤단층소묘%신경심리평분%비치태형혈관성인지공능장애
    cognitive function%single-photon emission computed tomography%neuropsychological test%vascular cognitive impairment with no dementia
    目的：应用单光子发射计算机断层扫描(SPECT)成像术研究非痴呆型血管性认知障碍(VCIND)患者的局部脑血流(rCBF)改变，并分析其与神经心理评分的关系。方法纳入①VCIND患者45例(VCIND组)，其中男25例、女20例；②认知功能正常脑卒中(SNC)患者28例(SNC组)，其中男16例、女12例；③健康对照者15例(HC组)，其中男6例、女9例。所有研究对象行一般检查、神经心理评定(MMSE量表、MoCA量表、CDR量表、NIHSS量表、ADL量表、Loeb量表、Hamilton抑郁量表)及SPECT rCBF检查。结果①与HC组比较，VCIND组两侧额叶、两侧顶叶上部、左侧丘脑rCBF明显降低(P<0.05)，SNC组左侧额叶、左侧顶叶下部、左侧颞叶、两侧丘脑以及两侧纹状体rCBF明显降低(P<0.05)；②与SNC组比较，VCIND组左侧额叶、左侧顶叶上部以及左侧丘脑rCBF明显降低(P<0.05)；③VCIND组内，左侧额叶、左侧顶叶上部、左侧丘脑均较右侧相应部位rCBF明显降低(P<0.05)；④相关分析显示VCIND组MMSE评分与左侧额叶、左顶叶上部、两侧颞叶内侧、左侧纹状体rCBF呈正相关(r=0.73~0.84，P<0.05)，MoCA评分与左侧额叶、右侧顶叶下部、两侧颞叶内侧rCBF呈正相关(r=0.65～0.85，P<0.05)。结论 SPECT探查VCIND患者rCBF改变具有重要临床意义，MMSE及MoCA评分与局部rCBF改变具有一定相关性。
    목적：응용단광자발사계산궤단층소묘(SPECT)성상술연구비치태형혈관성인지장애(VCIND)환자적국부뇌혈류(rCBF)개변，병분석기여신경심리평분적관계。방법납입①VCIND환자45례(VCIND조)，기중남25례、녀20례；②인지공능정상뇌졸중(SNC)환자28례(SNC조)，기중남16례、녀12례；③건강대조자15례(HC조)，기중남6례、녀9례。소유연구대상행일반검사、신경심리평정(MMSE량표、MoCA량표、CDR량표、NIHSS량표、ADL량표、Loeb량표、Hamilton억욱량표)급SPECT rCBF검사。결과①여HC조비교，VCIND조량측액협、량측정협상부、좌측구뇌rCBF명현강저(P<0.05)，SNC조좌측액협、좌측정협하부、좌측섭협、량측구뇌이급량측문상체rCBF명현강저(P<0.05)；②여SNC조비교，VCIND조좌측액협、좌측정협상부이급좌측구뇌rCBF명현강저(P<0.05)；③VCIND조내，좌측액협、좌측정협상부、좌측구뇌균교우측상응부위rCBF명현강저(P<0.05)；④상관분석현시VCIND조MMSE평분여좌측액협、좌정협상부、량측섭협내측、좌측문상체rCBF정정상관(r=0.73~0.84，P<0.05)，MoCA평분여좌측액협、우측정협하부、량측섭협내측rCBF정정상관(r=0.65～0.85，P<0.05)。결론 SPECT탐사VCIND환자rCBF개변구유중요림상의의，MMSE급MoCA평분여국부rCBF개변구유일정상관성。
    Aim To investigate the regional cerebral blood lfow (rCBF) changes in vascular cognitive impairment with no dementia (VCIND) patients with single-photon emission computed tomography (SPECT) and to analyze its relationship with neuropsychological score. Methods 45 cases of VCIND group (male&nbsp;25, female 20) were recruited and 28 cases of stroke with normal cognition (SNC) group (male 16, female 12) were recruited, and 15 cases of healthy control (HC) group (male 6, female 9) were recruited. All subjectsunderwent a general examination, neuropsychological test, brain SPECT perfusion imaging. Results Compared with the HC group, the rCBF in the bilateral frontal lobe, bilateral superior parietal lobe and left thalamus in the VCIND group were signiifcantly reduced (P<0.05). The rCBF of the left frontal lobe, left inferior parietal lobe, left temporal lobe and bilateral thalamus and striatum were signiifcantly reduced in SNC group (P<0.05). The rCBF of the left frontal lobe, left superior parietal lobe and left thalamus were signiifcantly lower in VCIND group than SNC group (P<0.05). Within the VCIND group the rCBF of the left frontal, left superior parietal lobe, and left thalamus were signiifcantly reduced compared with the right corresponding regions (P<0.05). Correlation analysis in VCIND group showed that, Mini Mental State Examination (MMSE) score was positively correlated with the rCBF of the left frontal lobe, left superior parietal lobe, bilateral medial temporal lobe, and left striatum (r=0.73-0.84, P<0.05). Montreal Cognitive Assessment (MoCA) score was positively correlated with the rCBF of left frontal lobe, right inferior parietal lobe, bilateral medial temporal lobe (r=0.65-0.85, P<0.05). Conclusion SPECT is of great signiifcance in detecting early rCBF changes in VCIND cases. MMSE and MoCA score have certain degree of correlation with rCBF changes.
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