摘要
目的:分析遗忘型轻度认知功能障碍(amnestic Mild Congnitive Impairment,a-MCI)患者的认知能力(cognitive abilities,cognitive ability)与其脑血管储备能力(cerebrovascular reserve,CVR)的关系。方法 :对2014年3月至2014年9月期间我院收治的47例遗忘型轻度认知功能障碍患者的临床资料进行回顾性研究。将这47例遗忘型轻度认知功能障碍患者作为观察组,再选取同期在我院进行常规体检的48例健康人作为对照组。在这两组人就诊时和就诊1年后,我院使用经颅多普勒超声屏气试验(transcranial Doppler breath-holding index)对其脑血管储备能力进行评价,并使用简易精神状态检测量表(mini-mental state examination,MMSE)和蒙特利尔认知评估量表(Montreal cognitive assessment,Mo CA)对其认知能力进行评价。评价结束后,对这两组人的屏气(breath-holding index,BHI)指数、MMSE(简易精神状态检测量表)评分和Mo CA(蒙特利尔认知评估量表)评分进行分析,弄清遗忘型轻度认知功能障碍患者的认知能力与其脑血管储备能力的关系。结果 :在就诊时,观察组遗忘型轻度认知功能障碍患者的屏气指数、MMSE评分和Mo CA评分明显低于对照组健康人,二者相比差异具有显著性(P<0.05)。在就诊1年后,观察组患者的屏气指数、MMSE评分和Mo CA评分均较就诊时有明显的下降,二者相比差异具有显著性(P<0.05)。观察组患者的屏气指数与其MMSE评分和Mo CA评分呈正相关关系(r=0.911,P<0.01)。结论:遗忘型轻度认知功能障碍患者的认知能力与其脑血管储备能力呈正相关关系。由此可见,脑血管储备能力的变化情况与遗忘型轻度认知功能障碍的发生和发展明确相关。临床医生应对上述情况加以注意。
Objective: to evaluate the cerebrovascular reserve(CVR) of patients with amnestic Mild Cognitive Impairment(a-MCI), and to investigate its significance in prognosis of the patients.Methods: 95 subjects were enrolled, including a normal control group and an a-MCI group, CVR of the patients was assessed by breath-holding index(BHI) via transcranial Doppler(TCD), and the cognitive function of the patients were evaluated using minimental state examination(MMSE) and Montreal cognitive assessment(Mo CA). After one year of follow-up, BHI and cognitive function of the patients were evaluated again, and the correlation between BHI and cognitive function of the patients was analyzed. Results: BHI of a-MCI patients was(0.82±0.23)%/s, significantly lower than that of normal control, which was(1.40±0.18)%/s. After one year of follow-up, MMSE and Mo CA scores and BHI of the a-MCI group all decreased to varying degrees, and MMSE and Mo CA scores was positively correlated with BHI, namely, the lower BHI, the lower MMSE and Mo CA scores(r=0.911, P<0.01).Conclusion: 1. Impaired cerebrovascular reactivity may play a role in amnestic mild cognitive disorders; 2. TCD-BHI assessment is of great significance in early diagnosis and prognosis of small blood vessel lesions in a-MCI patients.
