摘要
目的明确皮质下型血管性认知障碍(s-VCI)的影像标志物。方法 92例皮质下缺血性血管病(SIVD)患者,经神经心理检查和临床访谈,分为无认知障碍(NCI)组29例、血管性轻度认知障碍(VaMCI)组39例和血管性痴呆(VaD)组24例。登记并比较不同认知组患者的人口学、血管危险因素和影像学资料。结果三组患者在皮质下白质腔隙性梗死(LI)数量、白质病变(WML)评分、内侧颞叶萎缩(MTA)(均P<0.01)和皮质萎缩(CA)(P<0.05)评分方面的差异有统计学意义。其中,VaMCI和VaD组的白质LI数目高于NCI组(分别P<0.01和P<0.05));VaD组的WML程度重于VaMCI组和NCI组(均P<0.01);VaD组的MTA评分高于NCI组(P<0.01);VaD组和VaMCI组的CA评分高于NCI组(均P<0.05)。两个认知障碍组的WML程度、MTA评分、CA评分、皮质下白质LI数目(均P<0.01)和所有LI总数高于NCI组(P<0.05)。Logistic回归分析显示教育程度低、糖尿病、白质的LI、MTA和CA评分是s-VCI的独立危险因素。结论 s-VCI与低教育水平、糖尿病、皮质下白质损伤和皮质及内侧颞叶萎缩独立相关。
Objective To explore the neuroimaging markers of subcortical vascular cognitive impairment ( s-VCI) . Methods Based on the detailed neuropsychological tests and clinical interview , 92 subjects with subcortical ischemic vascular disease ( SIVD ) were recruited and classified into three groups according to their cognitive state, 29 patients with no cognitive impairment (NCI), 39 patients with vascular mild cognitive impairment ( VaMCI ) , and 24 patients with vascular dementia ( VaD ) . Their demographic , vascular risk factors and neuroimaging data were compared . Results The differences between the three groups in the number of subcortical white matter lacunar infarcts ( LI) as well as the scores of the white matter lesions ( WML) , medial temporal atrophy (MTA) and cerebral atrophy (CA) were statistically significant .Pairwised analysis showed that the numbers of LI within subcortical white matter in the VaMCI ( P<0.01 ) or VaD group ( P<0.05 ) were significantly higher than that in the NCI group .The scores of WML in the VaD group were significantly higher than that in the VaMCI or NCI group ( all P<0.01 ) .The scores of MTA in the VaD group were also significantly higher than that in the NCI group ( P<0.01 ) .The scores of CA in both groups of VaMCI and VaD were significantly higher than that in the NCI group (all P<0.05).The scores of WML, MTA, and CA, as well as the numbers of LI within subcortical white matter ( all P<0.05 ) and total LI numbers ( P<0.05 ) in patients with VCI were significantly higher than that in patients with NCI .Logistic regression analysis showed that low level of education , diabetes mellitus , the numbers of LI within subcortical white matter , the scores of MTA and CA were independent risk factors for s-VCI . Conclusion s-VCI is independently related to low level of education , diabetes mellitus , subcortical white matter injuries , as well as cortical and medial temporal atrophy .
出处
《神经病学与神经康复学杂志》
2013年第3期143-146,150,共5页
Journal of Neurology and Neurorehabilitation
基金
上海市卫生局科研课题(编号:20124251)
上海交通大学医工(理)交叉基金(编号:YG2012MS08)
