慢性脑供血不足患者认知功能障碍及其危险因素研究

摘要

目的 探究慢性脑供血不足(CCCI)患者认知功能障碍及其危险因素.方法 选择2015年4月至2016年4月收治的慢性脑供血不足伴有认知功能障碍患者89例作为观察组,另选取同期收治的单纯慢性脑供血不足患者89例作为对照组,检测两组认知功能及脑血流量,并分析慢性脑供血不足伴认知功能障碍患者的危险因素.结果 观察组MoCA检测评分为(16.5±2.8)分,明显低于对照组的(27.7±2.3)分(t=7.214,P<0.05).观察组脑深部白质、丘脑、枕叶、顶叶、颞叶、额叶的区域性脑血流(rCBF)均低于对照组(P均<0.05).高龄、有脑白质疏松症、脑血流量异常、颈动脉内中膜厚度Ⅱ级病变以上是脑供血不足并发认知功能障碍的独立危险因素.结论 因CCCI长期缺血缺氧常使额叶、颞叶、深部白质受损,而易诱发认知功能障碍,且年龄、脑白质疏松症、脑血流量异常、颈动脉内中膜厚度Ⅱ级病变是其独立风险因素,对CCCI患者诱发认知功能障碍可产生直接影响.%Objective To explore the chronic cerebral cognitive dysfunction in patients with chronic cerebral circulatory insufficiency (CCCI)and its risk factors. Methods A total of of 89 patients with chronic cerebral blood supply insuficiency associated with cognitive dysfunc-tion in this hospital during April 2015 to April 2016 were allocated in observation group and other 89 patients with same kind of disease during the same period were selected as control group,patients in these 2 groups were examined for their disorder in cognitive function and amount of cerebral blood supply,and their risk factors had been analyzed. Results The MoCA test scores in patients of observation group were 16. 5 ± 2. 8,these were significantly lower than those (27. 7 ± 2. 3)of patients in control group (t = 7. 214,P < 0. 05). The regional cerebral blood flow (rCBF) in deep brain white matter,thalamus,occipital lobe,parietal lobe,temporal lobe and frontal lobe in patients of observation group were lower than those of patients in control group (P < 0. 05). Age,cerbro-white matter porosis,abnormal cerebral blood flow,thickness of carotid intima-media above grade Ⅱ lesions were independent risk factors for insuffiency of cerebral blood supply and cognitive dysfunction. Conclusion Due to long-term CCCI,frontal lobe of brain is impaired by ischemic hypoxia,frontal and temporal lobes and deep white matter are easy to induce cogni-tive dysfunction,and age,cerebral white matter abnormalities,abnormal cerebral blood supply and thickness of carotid intima-media reached lev-el II are independent risk factors,patients with CCCI can produce direct influence on cognitive dysfunction.