摘要
目的 明确皮质下小血管病所致轻度血管性认知障碍（mild vascular cognitive impairment due to subcortical small vessel disease,mVCI-SSVD）的危险因素及临床特征.方法 收集56例mVCI-SSVD患者的人口学资料、血管危险因素、现病史、既往史,并进行详细的神经系统体检及美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）和Hachinski缺血积分（Hachinski ischemic score,HIS）评分.将mVCI-SSVD患者的人口学资料、血管危险因素与80名健康对照老人进行比较,最终明确mVCI-SSVD患者的危险因素及临床特征.结果 患者组吸烟史[39.3%（22/56）]、高血压[67.9%（38/56）]、糖尿病[25.0%（14/56）]等血管危险因素阳性比例高于健康对照组[21.3%（17/80）,47.5%（39/80）,11.3%（9/80）],2组之间的OR值[2.32（95% CI1.05～5.13）,2.15（95% CI 1.02～4.54）,2.26（95% CI 0.86～5.92）]均有统计学意义（P=0.039、0.045、0.047）,而高脂血症和心脏病与对照组比较差异无统计学意义.50.0%（28/56）的mVCI-SSVD患者有明确的卒中病史,26.8%（15/56）的患者认知障碍急性起病,局灶体征见于20例患者（35.7%）.HIS≤4分24例（42.9%）,NIHSS评分0分38例（67.9%）.结论 吸烟、高血压、糖尿病是mVCI-SSVD的危险因素,而高脂血症和心脏病不增加mVCI-SSVD的风险;与大血管病变导致的认知障碍不同,约一半的mVCI-SSVD患者缺乏卒中病史,多数患者认知障碍慢性起病,缺乏明显的局灶体征.
Objective To determine the risk factors and clinical features of mild vascular cognitive impairment due to subcortical small vessel disease （mVCI-SSVD）.Methods Detailed demographic data,vascular risk factors, past and present history were collected and carefully neurological examination, National Institutes of Health Stroke Scale （NIHSS）, as well as Hachinski ischemic score （HIS） were performed on 56 mVCI-SSVD patients.Further, the demographic data and vascular risk factors of mVCI-SSVD patients were compared with those of 80 normal control subjects.Results Proportions of smoking （39.3% （22/56））, hypertension （67.9% （38/56））, and diabetes （25.0% （14/56）） were higher in the patient group than in the normal control group （21.3% （17/80） , 47.5% （39/80）, 11.3% （9/80））.Odds ratio （2.32（95% CI 1.05-5.13）,2.15 （95% CI 1.02-4.54）,2.26（95% CI 0.86-5.92）） between the two groups was statistically significant （P value： 0.039, 0.045, 0.047）.There was no difference in terms of hyperlipidemia and cardiac disease between groups.Fifty percent （28/56） mVCI-SSVD patients had a clear stroke history.Twenty-six point eight percent （15/56） patients developed the cognitive impairment with an acute onset.Neurological focal signs presented in 20 patients （35.7%）.Twenty four （42.9%） patients with HIS ≤ 4 points.Thirty eight cases （67.9%） scored 0 on NIHSS.Conclusions Current study suggested that smoking, hypertension, and diabetes may be risk factors for mVCI-SSVD.While hyperlipidemia and cardiac disease do not increase the risk of mVCI-SSVD.Unlike mVCI caused by large vessel disease, about half mVCI-SSVD patients lack of stroke history.Most patients show a relatively insidious onset and free of significant neurological focal signs.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2011年第3期167-170,共4页
Chinese Journal of Neurology
基金
基金项目：“十一五”国家科技支撑计划基金资助项目（2006BA102801）
国家自然科学基金青年科学基金资助项目（30900394）
首都医学发展基金资助项目（2009-3144）
关键词
认知障碍
痴呆
血管性
危险因素
Cognition disorders
Dementia,vascular
Risk factors
