摘要
目的探究脑小血管病(CSVD)MRI总负荷评分与CSVD患者认知功能及运动障碍的关系。方法选择2019年1月至2023年1月海安市人民医院收治的103例CSVD患者,其中男性78例,女性25例;年龄40~82岁,平均年龄61.62岁;身体质量指数(BMI)18.3~27.2 kg/m^(2),平均BMI 23.57 kg/m^(2);饮酒史43例,吸烟史51例;合并冠心病33例,合并高血压52例,合并高血脂40例,合并糖尿病28例。行MRI检查。按照CSVD MRI总负荷评分进行分组,比较各组临床资料。采用线性回归分析CSVD MRI总负荷程度与认知功能的关系。以Tinetti平衡与步态量表(POMA)评分<25分作为发生运动障碍,多因素Logistic回归分析影响CSVD患者发生运动障碍的相关因素。结果将患者分为A组(n=27,0分)、B组(n=41,1~2分)、C组(n=35,3~4分)。各组在BMI、合并高血压、高血脂比例、简易智力状态量表(MMSE)评分、语言流畅性实验(VFT)评分、听觉学习测试-瞬时记忆(AVLT-I)评分、Stroop颜色词测试(SCWT)评分、POMA评分方面差异有统计学意义(P<0.05)。线性回归分析显示,与A组比较,B组SCWT-A评分、SCWT-B评分、SCWT-C评分升高,C组MMSE评分、VFT评分、AVLT-I评分下降,SCWT-A评分、SCWT-B评分、SCWT-C评分升高(P<0.05)。多因素Logistic回归分析显示,年龄、BMI、CSVD MRI总负荷程度是患者发生运动障碍的独立影响因素(P<0.05)。结论轻度CSVD MRI总负荷可能只影响注意力、信息处理及执行功能,而随着MRI总负荷增加可出现广泛认知功能损害,同时总负荷增加也是发生运动障碍的独立影响因素,可为临床评估病变程度、制定有效干预方案提供参考。
Objective To explore the correlation between total burden score of MRI and cognitive function as well as mo-tor impairment severity in patients with cerebral small vessel disease(CSVD).Methods From January 2019 to January 2023,a total of 103 CSVD patients were enrolled,which included 78 males and 25 females,aged 40-82 years old with mean age of 61.62 years old;body mass index(BMI)was 18.3-27.2 kg/m^(2) with mean BMI of 23.57 kg/m^(2).There were 43 cases of alcohol consumption,and 51 cases of smoking;33 cases were combined with coronary heart disease,52 of hypertension,40 of hyperlipidemia and 28 of diabetes mellitus.All of them performed MRI,classified to 3 groups according to total burden score of CSVD MRI,and clinical data of 3 groups were compared.The linear regression was used to analyze the correlation between total CSVD MRI and cognitive function.The Tinetti Balance and Performance-Oriented Mobil-ity Assessment(POMA)score<25 scores was used as the occurrence of dyskinesia,and multivariate Logistic regression analysis was used to analyze the related factors affecting the occurrence of dyskinesia in CSVD patients.Results All of them were classified into group A(n=27,0 score),group B(n=41,1-2 scores),group C(n=35,3-4 scores).There were significant differences in BMI,hypertension,hyperlipidemia,mini-mental state examination(MMSE)score,verbal flu-ency test(VFT)score,auditory verbal learning test-instantaneous memory(AVLT-I)score,stroop color word test(SCWT)score and POMA score among 3 groups(P<0.05).The linear regression analysis showed that compared with group A,SCWT-A score,SCWT-B score and SCWT-C score in group B was significantly increased,MMSE score,VFT score and AVLT-I score was significantly decreased,SCWT-A score,SCWT-B score and SCWT-C score was significantly increased in group C(P<0.05).The multivariate Logistic regression analysis showed that age,BMI,and total MRI load of CSVD were independent influencing factors of dyskinesia in patients(P<0.05).Conclusion It is demonstrated that the mild total MRI burden in CSVD may only affect attention,information processing and executive function,while extensive cognitive impairment occur with increased total burden of MRI,and the increased total burden is also an independent influence on the occurrence of motor impairment,which provides the reference for clinical assessment of the extent of lesions and the development of effective intervention plans.
作者
郜俊锋
曹建
邵祥忠
GAO Jun-feng;CAO Jian;SHAO Xiang-zhong(Department of Neurology,Haian People’s Hospital,Haian 226600,Jiangsu,China)
出处
《生物医学工程与临床》
CAS
2023年第6期753-758,共6页
Biomedical Engineering and Clinical Medicine
基金
2020年度南通市市级科技计划(指导性)项目(MSZ20090)。
关键词
脑小血管病(CSVD)
MRI总负荷
认知功能
运动障碍
cerebral small vessel disease(CSVD)
total burden score of MRI
cognitive function
motor impairment
作者简介
郜俊锋(1982—),男,江苏海安市人,本科,副主任医师,主要从事脑血管病、帕金森病研究。电话:13912403029。E-mail:7534318@qq.com;通信作者:邵祥忠(1969—),男,江苏海安市人,本科,主任医师,主要从事脑血管病、神经介入研究。电话:13506299026。E-mail:shaoxz23@163.com。
