慢性脑血流低灌注相关的脑白质病变与认知功能障碍关系的临床分析-现代医学

慢性脑血流低灌注相关的脑白质病变与认知功能障碍关系的临床分析

单位：1. 保定市第一中心医院神经内一科, 河北保定 071000;
2. 保定市第一中心医院内分泌实验室, 河北保定 071000;
3. 保定市第一中心医院科教科, 河北保定 071000;
4. 保定市第一中心医院内分泌一科, 河北保定 071000

关键词：慢性脑血流低灌注脑白质损伤程度认知功能障碍脑CT灌注成像相关性

分类号：R743;R814.42;R742

出版年·卷·期（页码）：2018·37·第九期（987-991）

摘要：

目的：探讨慢性脑血流低灌注相关的脑白质病变与认知功能障碍的相关性。方法：选择2016年5月至2017年10月我院收治的慢性脑供血不足患者120例，设为观察组；选择无神经系统病变患者120例，设为对照组。两组患者入院后均行脑部CT灌注成像检查，同时完成患者脑白质损伤评分。采用蒙特利尔认知评估量表、简易智能精神状态量表、日常生活活动量表对两组患者认知功能情况进行评估，采用相关性分析软件对脑白质损伤评分与认知功能障碍评分进行相关性分析。结果：观察组慢性脑血流低灌注相关脑白质损害评分、达峰时间、平均通过时间、局部脑部血流量、局部脑血容量，均低（少）于对照组（P<0.05）；观察组慢性脑血流低灌注相关脑白质损害蒙特利尔认知评估量表、简易智能精神状态量表评分及日常生活活动量表评分均低于对照组（P<0.05）；相关性分析结果表明，脑CT灌注下脑白质损害评分、达峰时间、平均通过时间、局部脑部血流量、局部脑血容量与蒙特利尔认知评估量表、简易智能精神状态量表评分及日常生活活动量表评分呈正相关（P<0.05）。结论：慢性脑血管低灌注所致的脑白质损伤患者常伴有不同程度的认知功能障碍，脑CT灌注成像检查能评估患者病情严重程度，对早期轻度认知功能障碍的发现尤为重要，能为临床治疗提供影像学依据，并指导临床早期治疗，有效延缓患者痴呆的发生。

Objective: To investigate the correlation between the degree of white matter injury caused by chronic cerebral blood flow hypoperfusion and cognitive dysfunction. Methods: 120 patients with chronic cerebral circulation insufficiency admitted to our hospital from May 2016 to October 2017 were selected as the observation group, and 120 patients without neurological diseases admitted to hospital during the same period were selected as the control group. The two groups were examined by cerebral CT perfusion imaging after admission, and the assessments of white matter injury in the two groups were done at the same time. The NCA, MMSE, ADL were used for the cognitive function assessment in the two groups; The correlation analysis of cognitive dysfunction and cerebral white matter injury score was done. Results: The white matter damage score, the peak time, the average transit time, local brain blood flow and local cerebral blood volume in the observation group were lower(less) than those in the control group(P<0.05);Montreal cognitive assessment scale, Mini Mental State score and activities of daily living scores in the observation group were lower than those in the control group(P<0.05); SPSS Pearson correlation analysis showed that the damage of brain white matter brain CT perfusion score, the peak time, the average transit time, local brain blood flow and local cerebral blood volume are positively correlated with Montreal cognitive assessment scale scores, Mini Mental State Scale scores and activities of daily living scores(P<0.05). Conclusion: The patients with white matter injury induced by chronic cerebral blood flow hypoperfusion often have varying degrees of cognitive dysfunction;cerebral CT perfusion imaging can evaluate the severity of patients' condition effectively, especially for the early discovery of disease, which can provide imaging evidence for clinical treatment to delay the onset of Alzheimer's disease.

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