摘要
目的探讨脑内微出血(CMBs)与患者认知功能损害、腔隙性脑梗死(LI)及脑白质疏松(LA)的相关性。方法连续选取2011年7月至2012年3月首次头部MRI(T1、T2、T2-Flair)检查显示存在LI和/或LA的患者38例,进一步行头部磁敏感加权成像(SWI)检查,按是否存在CMBs病灶分为CMBs组和非CMBs组。记录并分析与CMBs有关的常见脑血管病危险因素;检测血脂;用MMSE及Mo CA量表评价认知功能;分析CMBs与LA及LI的相关性。结果 CMBs组13例,年龄(73.8±7.9)岁;11例(84.6%)有高血压病史。非CMBs组25例,年龄(64.1±9.9)岁;13例(52.0%)有高血压病史。两组间年龄、高血压病史差异有统计学意义(P均<0.05);两组间性别、糖尿病病史、吸烟史、饮酒史、家族史及胆固醇水平等比较差异无统计学意义(P均>0.05)。Logistic回归分析表明,CMBs的存在与年龄相关(OR=1.11,P<0.05)。CMBs组共有CMBs病灶58个,包括:基底节及丘脑36个、皮质及皮质下14个、脑干3个、小脑5个。Spearman等级相关检验表明,CMBs的存在与LA分数(r=0.665,P<0.01)及LI灶数目(r=0.365,P<0.05)呈正相关,CMBs数目与LA分数(r=0.643,P<0.01)及LI病灶数目(r=0.474,P<0.01)呈正相关;Mo CA总分与LA分数存在负相关(r=-0.339,P<0.05),与CMBs数目、LI病灶数目无明显相关性。CMBs组的MMSE及Mo CA评分明显低于非CMBs组,差异均有统计学意义(P均<0.05);Mo CA总分与LA分数负相关(r=-0.339,P<0.05),与CMBs数目、LI病灶数目无相关性。结论 CMBs与患者的年龄和是否存在LI、LA相关。CMBs的存在与数目及LA评分与患者认知功能损害相关。
Objective To explore the relation of cerebral microbleeds （CMBs） to cognitive function impairment , lacunar cerebral infarction（LI） and leukoaraiosis （LA）. Methods Total 38 patients with LI and LA confirmed by first head MRI （T1 ,T2, T2 -Flair）were selected consecutively between July 2011 to March 2012. According to the examination results of magnetic susceptibility weighted imaging（SWI）, the patients were divided into CMBs group（ 13 cases with CMBs focus） and non CMBs group（25cases without CMBs focus） . The cerebrovascular disease related risk factors of CMBs were recor- ded and analyzed. The blood lipid profile was examined. The cognitive functions were assessed by Mini Mental State Exam- ination（MMSE） and Montreal Cognitive Assessment（ MoCA）, and the correlations of cerebral CMBs to LI and LA were analyzed. Results There were significant differences in age [ （73.8 ±7.9 ） years vs （ 64.1 ± 9.9 ） years,P 〈0. 05 ] and rate of hypertension history[ 84.6% vs 52.0% ,P 〈0.05 ] between CMBs group and non CMBs group, but there were no significant differences in gender, diabetes history, smoking history, driking history, family history and blood cholesterol level between CMBs group and non CMBs group（ all P 〉 0.05 ）. Further , the logistic regression analysis showed that the exist- ence of CMBs was related to age （r = 1.11, P 〈 O. 05 ）. In CMBs group, a total of 58 CMBs focus including 36 in basal
ganglia and thalamus, 14 in cortical and subcortical sites, 3 in brainstem, 5 in cerebellum were found. Spearman rank cor- relation test showed that existence of CMBs were positively correlated with the LA score（ r =0. 665 ,P 〈0.01 ） and the fo- cus number of LI （ r = 0. 365, P 〈 0.05 ） ; while focus number of CMBs were positively correlated with the LA score （ r = 0. 643, P 〈0. 01 ） and the focus number of LI （ r = 0. 474, P 〈 0.01 ）. The scores of MMSE and MoCA in CMBs group were all lower than those in non CMBs group（ all P 〈 0.05 ）. MoCA total score was negatively correlated with LA score（ r = - 0. 339,P 〈 0. 05 ） , but was not correlated with the lesion numbers of CMBs and LI. Conclusions CMBs is related to patients＇age and the existence of LI and/or LA . The existence and focus number of CMBs and LA score are associated with patients＇cognitive function impairment.
出处
《中国临床研究》
CAS
2015年第8期1003-1006,共4页
Chinese Journal of Clinical Research
基金
天津市科技支撑计划重点项目(13ZCZDSY02000)
