老年遗忘型轻度认知障碍患者认知特征与脑血管储备的相关性分析

摘要

Objective To Investigate the characteristics of Cognitive function in elderly patients with mild cognitive impairment and its correlation with cerebrovascular reserve.Methods 30 patients with amnestic mild cognitive impairment (aMCI),30 patients with vascular cognitive impairmem-no dementia (VCIND),and 30 healthy people into aMCI group,VCIND group and control group were included in the present study.The mean blood flow velocity (MBFV) and breath holding time(BHI) were measured by transcranial doppler(TCD).The memory impairment was assessed by explicit memory Correlations of aMCI and VCIND with mini-mental state examination (MMSE) and montreal cognitive scores (MoCA) were analyzed.Results The MBFV and BHI in the control group were significantly higher than those in the aMCI group and the VCIND group (P＜0.05).There was no significant difference between the aMCI group and the VCIND group (P＞0.05).The scores of MoCA in the control group were significantly higher than those in the aMCI group and the VCIND group(P＜0.05).There was no significant difference between the aMCI group and the VCIND group (P＞0.05).The difference of MMSE between the three groups was not statistically significant (P＞0.05).There was no significant difference between groups MCI and VCIND in immediate recall (P＞0.05).The scores of delayed recall and delayed recognition in aMCI group were significantly lower than those in VCIND group and control group (P＜ 0.05).BHI was positively correlated with MMSE and MoCA scores (P＜0.05).Conclusion aMCI is mainly characterized by delayed recall and delayed recognition impairment.Impaired cerebrovascular reserve may be associated with mild cognitive impairment in patients with aMCI,and the use of TCD to detect MBFV does not distinguish between aMCI and VCIND,and BHI is important in the early diagnosis of brain microvascular lesions in patients with aMCI.%目的 探讨老年遗忘型轻度认知障碍患者认知功能特征及与脑血管储备的相关性.方法 选取2016年1月～2017年1月于我院神经内科就诊的30例遗忘型轻度认知障碍(amnestic mild cognitive impairment,aMCI)患者设为aMCI组,30例非痴呆血管性认知损害患者(vascular cognitive impairmem-no dementia,VCIND)设为VCIND组,将30例正常体检人群设为对照组.采用经颅多普勒超声(Transcranial Doppler TCD)检测双侧大脑中动脉的平均血流速度(meanblood flow velocity,MBFV)以及屏气指数(Breath holding time,BHI),用外显记忆测试记忆损害情况,分析两者与简易精神状态(MMSE)及蒙特利尔认知(MoCA)评分的相关性.结果 对照组MBFV、BHI均显著高于aMCI组与VCIND组,差异有统计学意义(P＜0.05);aMCI组与VCIND组差异无统计学意义(P＞0.05);对照组MoCA评分均显著高于aMCI组与VCIND组,差异有统计学意义(P＜0.05),aMCI组与VCIND组差异无统计学意义(P＞0.05),3组MMSE差异无统计学意义(P＞0.05);aMCI组与VCIND即刻回忆差异无统计学意义(P＞0.05),aMCI组延时回忆、延时再认评分均显著低于VCIND组与对照组,差异均有统计学意义(P＜0.05);BHI与MMSE、MoCA评分均呈正相关(P＜0.05).结论 aMCI主要表现为延时回忆、延时再认损害,脑血管储备受损可能与aMCI患者轻度认知障碍有关,采用TCD检测MBFV无法辨别aMCI与VCIND,BHI对aMCI患者脑微小血管病变的早期诊断具有重要意义.