文章摘要
赵静 ，常文龙 ，宋伟丽 ，刘永刚 ，王潇 ，王宁 ，李宝新.脑小血管病患者认知功能障碍与脑白质完整性及脑血流灌注的关系[J].神经损伤功能重建,2019,14(9):433-436
脑小血管病患者认知功能障碍与脑白质完整性及脑血流灌注的关系
Relationship between Cognitive Impairment and White Matter Integrity, Cerebral Blood FlowPerfusion in Patients with Cerebral Small Vessel Disease
  
DOI：
中文关键词: 脑小血管病  认知功能障碍  脑白质  脑血流量  弥散张量成像
英文关键词: cerebral small vessel disease  cognitive impairment  white matter  cerebral blood flow  diffusion tensor imaging
基金项目:保定市科技支撑计 划项目 （NO. 17ZF253）
作者单位
赵静a ，常文龙b ，宋伟丽c ，刘永刚a ，王潇c ，王宁a ，李宝新d 保定市第一中心医 院 a. 神经内一科， b. 内分泌实验室， c. 科教科，d. 内分 泌一科 
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中文摘要:
      目的：探讨脑小血管病（CSVD）患者轻度认知功能障碍（MCI）与脑白质完整性、脑血流灌注的关系。 方法：选取 52 例 CSVD 伴 MCI 患者为 MCI 组，同期健康体检者 40 例为对照组。采用蒙特利尔认知量表 （MoCA）评价认知功能，采用磁共振动脉自旋标记（ASL）灌注成像测定脑血流量（CBF）和磁共振弥散张量 技术（DTI）测定各向异性分数（FA）、平均弥散系数（ADC）等。结果：MCI组MoCA量表总分、视空间/执行、 命名、注意/计算力、语言、抽象思维及延迟记忆评分均低于对照组（P<0.05）；与对照组相比，MCI组双侧半卵 圆中心、额叶、顶叶FA值、CBF均降低（P<0.05），双侧额叶、顶叶的ADC值高于对照组（P<0.05）；右侧半卵圆 中心、双侧额叶、顶叶的 FA 值与 CBF 呈正相关（P<0.05），双侧额叶和顶叶的 ADC 值与 CBF 呈负相关（P< 0.05）；右侧半卵圆中心、双侧额叶的FA值与MoCA评分呈正相关（P<0.05），双侧额叶的ADC值与MoCA评 分呈负相关（P<0.05）；双侧额叶、顶叶的CBF与MoCA评分呈正相关（P<0.05）。结论：脑白质完整性损伤尤 其是颞叶损伤是CSVD患者伴发MCI的重要标志，且与脑血流灌注有关。
英文摘要:
      To investigate the relationship between mild cognitive impairment (MCI) and white matter integrity, cerebral blood flow perfusion in patients with cerebral small vessel disease (CSVD). Methods: A total of 52 CSVD patients with MCI were recruited and assigned to the MCI group, and 40 healthy volunteers were selected as the control group. Cognitive function was evaluated by the Montreal Cognitive Assessment Scale (MoCA); cerebral blood flow (CBF) was measured by Arterial Spin Labeling (ASL) of MR perfusion imaging technique; fractional anisotropy (FA) values and the apparent diffusion coefficient (ADC) were measured by diffusion tensor imaging (DTI). Results were analyzed to evaluate the relationship between severity of cognitive impairment and cerebral blood flow perfusion. Results: The total MoCA scale scores and visual space/execution, naming, attention/calculation, language, abstract thinking, and delayed memory scores in MCI group were significantly lower than those in control group (P<0.05). Compared with the control group, the MCI group showed decreased FA values and CBF in the bilateral centrum semiovale, bilateral frontal lobe, and apical frontal lobe (P<0.05) and increased ADC in the bilateral frontal lobe and apical frontal lobe (P<0.05). FA values in the right centrum semiovale, bilateral frontal lobe, and apical frontal lobe were positively correlated with CBF (P<0.05), and the ADC in the bilateral frontal lobe and apical frontal lobe were negatively correlated with CBF (P<0.05). FA values in the right centrum semiovale and bilateral frontal lobe were positively correlated with the MoCA score (P<0.05), and the ADC in the bilateral frontal lobe was negatively correlated with the MoCA score (P<0.05). CBF in the bilateral frontal lobe and apical frontal lobe was positively correlated with the MoCA score (P<0.05). Conclusion: In CSVD patients, the integrity of white matter is an important imaging marker of MCI and shows a relationship to cerebral perfusion.
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