首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 109 毫秒
1.
脑卒中所伴发的血管性认知功能损害(VCI)已成为影响老年人健康和生活质量的重要和常见原因.VCI是迄今为止惟一可防治的痴呆,故脑卒中前如能早期发现高危人群的认知功能障碍,对延缓及逆转病情具有重要意义.糖尿病、高血压、高脂血症、冠心病等患者是脑卒中潜在的危险人群,但有关高危人群的早期VCI的研究较少.该研究采用蒙特利尔认知评估量表(MoCA)和简明精神状态量表(MMSE)对作者医院就诊的具有二项及以上危险因素但无脑卒中患者的认知功能进行检测,旨在探讨脑卒中高危人群早期认知功能障碍发生情况及相关因素分析.  相似文献   

2.
神经心理量表在血管性认知功能损害筛查中的应用   总被引:6,自引:1,他引:5  
在老年期痴呆中,血管性痴呆占的比例较高,是相对可干预的,因此对于脑血管病后认知功能损害的早期筛查诊断就显得尤为重要。而血管性认知功能损害(vascular cognitive impairment,VCI)与Alzheimer's病(AD)引起的认知功能障碍是有差别的。目前用于认知功能障碍和痴呆筛查的量表,大多用于Alzheimer's病(AD)的筛查诊断,如简易精神状态量表(MMSE)、修订简易精神状态量表(3MS)、长谷川痴呆量表(HDS)等,而对于VCI的筛查量  相似文献   

3.
血管性认知功能损害(vascular cognitive impairment,VCI)是由脑血管病危险因素(如高血压、糖尿病和高血脂等)明显(如脑梗死和脑出血等)或不明显的脑血管病(如白质疏松和慢性脑出血)引起的从轻度认知功能障碍(MCI)到痴呆的一大类综合征[1].据统计,在年龄高于65岁的人群中,大约有5%患有VCI[2],早期诊断和干预VCI被认为是延缓认知损害发展,阻止其进展成为血管性痴呆(vascular de-memtia,VaD)的关键所在.目前,在临床工作中,VCI的诊断主要依赖于各种标准化的神经心理学测验量表,但任何一种量表或行为学检测工具都具有其局限性,只能作为重要的参考资料,诊断还需结合患者的临床表现、既往病史、神经影像学检测结果、电生理、神经生化学检查结果等.  相似文献   

4.
概述皮质下缺血性脑血管病(subcortical ischemic vascular diseases,SIVD)是造成血管性认知功能损害(vascular cognitive impairment,VCI)的重要原因,它所导致的认知损害是VCI中具有同质性和最为常见的亚型(皮质下型VCI)。VCI覆盖了从轻微的  相似文献   

5.
目的:探讨S100β与血管性认知损害(VCI)的关系。方法:①认知功能评价:运用简易智能状态量表(MMSE)及临床记忆量表(CMS)评估认知功能;②分组:轻度VCI组25例,中、重度VCI组33例;无认知损害脑梗死组30例及正常对照组30例;③用酶联免疫吸附法(ELISA)测定患者及对照组血清S100β含量。结果:中、重度VCI组的血清S100β浓度[(0.64±0.06)μg·L-1]显著性高于轻度VCI组[(0.42±0.08)μg·L-1]、无认知损害脑梗死组[(0.41±0.12)μg·L-1]及正常对照组[(0.39±0.11)μg·L-1],均具有显著性差异(P<0.05);轻度VCI组的血清S100β浓度稍高于无认知损害脑梗死组及正常对照组,但无显著性差异(P>0.05);相关性分析示中、重度VCI组MMSE总分及记忆商(MQ)值皆与血清S100β含量呈显著性负相关(P<0.05),而轻度VCI组MMSE及MQ值均与血清S100β含量无显著性相关(P>0.05)。结论:血清S100β有可能作为观察中、重度血管性认知(包括记忆)损害的生化指标。  相似文献   

6.
血管性认知功能损害(VCI)的早期诊断和干预对防止其进展成为严重的血管性痴呆具有重要价值。虽然脑脊液变化能反映中枢神经系统疾病的真实情况,但腰椎穿刺不是常规检查手段。本文就血液中β-淀粉样蛋白、tau蛋白、胆固醇、同型半胱氨酸和C反应蛋白等生物学指标在VCI的研究进展进行综述,我们认为血液生物学指标有望用于VCI早期诊断。  相似文献   

7.
血管性认知损害   总被引:2,自引:0,他引:2  
血管性痴呆是发生在中老年人群中最常见的痴呆之一,近年来在深入研究该病防治的基础上,又提出了血管性认知损害(vascular cognitive impairment,VCI)这一新术语。认为深入研究VCI,有助于对血管性因素和血管病引起的认知损害或痴呆的理解以及早期诊断和早期治疗。本文就VCI的有关研究进展做一介绍。  相似文献   

8.
血管因素是独立于年龄的导致痴呆的第二大危险因素.在血管性认知损害(VCI)早期即无痴呆型血管性认知功能障碍(VCIND)甚至认知损害发生之前,血管性因素以及脑血管病是唯一可治疗的,并且能够延缓甚至逆转痴呆进展的干预靶点.因此早期诊断出VCIND的病例,治疗血管性因素及脑血管病,有利于VCI的一级预防和二级预防.现对VCIND的诊断、预防和治疗的进展作一综述.  相似文献   

9.
血管性认知功能障碍(VCI)是指血管因素导致的从轻度认知功能障碍到痴呆的一大类综合征,包括血管性非痴呆性认知功能障碍( VCI-ND),血管性痴呆(VD)和混合型痴呆(MD)[1].VCI概念的提出弥补了VD概念的滞后性,体现了早期预防和早期干预的新观念.VD是迄今为止惟一可以预防的痴呆,早期治疗具有可逆性,在日常生活受到影响前进行干预,可避免发展到不可逆的VD晚期阶段[2,3].并且,近年来研究[4-6]发现,VCI与Alzheimer病(AD)具有许多共同的病理基础、危险因素和可能的相互作用机制,因此,有关参与VCI进展的危险因素的资料对于痴呆的一级和二级预防具有至关重要的作用.鉴于此,现就近年来VCI危险因素的研究进展综述如下.  相似文献   

10.
血管性认知损害(vascularcognitiveimpairment,VCI)指与脑血管疾病相关的所有不同方式和不同程度的认知功能损害。临床上VCI患者常常伴有不同程度的白质损伤,我们测定94例VCI患者血清髓鞘碱性蛋白(myelinbasicprotein,MBP)含量,探讨VCI患者白质损伤与MBP的关系及其意义。资料和  相似文献   

11.
血管性认知障碍(vascular cognitive impairment,VCI)是由脑血管病危险因素(如高血压、糖尿病、高脂血症和高同型半胱氨酸血症等)、显性脑血管病(出血性及缺血性卒中)及非显性脑血管病(脑白质疏松和慢性脑缺血等)引起的一组从轻度认知功能损害到痴呆的临床综合征。非痴呆性血管性认知障碍(vascular cognitive impairment-no dementia,VCIND)是VCI的早期阶段,其中约一半患者会在5年内进展为痴呆。血管性痴呆(vascular dementia,VD)在治疗上尚未发现行之有效的方法,但又是唯一可以预防的痴呆。发现VCIND危险因素并进行早期干预,对于寻求延缓痴呆进展的二级预防策略至关重要。现从VCIND的概念、流行病学、诊断标准及影响因素等方面进行综述,以期能够早期识别相关危险因素,防治VCI。  相似文献   

12.
There has been a move in recent years to recognize that the most effective treatment for vascular dementia, and for the mixed component of mixed vascular dementia and Alzheimer's disease, lies not in treatment but in prevention. This requires that cases be identified before the onset of vascular damage (a stage termed "brain-at-risk") or, failing this, as soon as possible but certainly before dementia has developed. These early stages are termed vascular cognitive impairment (VCI). No criteria exist for this early stage of cognitive loss due to cerebrovascular disease and relatively little data exist to indicate how such cases might be identified. The data that do exist suggest that many of the traditional "vascular" features of sudden onset and stepwise progression, etc., are not common in VCI and new criteria will be needed to identify cases. This paper summarizes the data that describe the clinical, neuropsychological, and radiological features that are to be expected in VCI.  相似文献   

13.
Vascular cognitive impairment (VCI) was proposed as an umbrella term to include subjects affected with any degree of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from mild cognitive impairment (MCI) to vascular dementia. VCI may or may not exclude the host of "focal" circumscribed impairments of specialized functions such as language (aphasia), intentional gesture (apraxia), or categorical recognition (agnosia), among others, that may result from a stroke. Therefore, there are no universally accepted diagnostic criteria for VCI. We conclude that this concept could be more useful if it were to be limited to cases of vascular MCI without dementia, by analogy with the concept of amnestic MCI, currently considered the earliest clinically diagnosable stage of Alzheimer disease (AD). In agreement with our view,the Canadian Study on Health and Aging successfully implemented a restricted definition of VCI, excluding cases of dementia (i.e., vascular cognitive impairment no dementia, VCI-ND). The Canadian definition and diagnostic criteria could be utilized for future studies of VCI. This definition excludes isolated impairments of specialized cognitive functions.Vascular dementia (VaD): The main problem of this diagnostic category stems from the currently accepted definition of dementia that requires memory loss as the sine qua non for the diagnosis. This may result in over-sampling of patients with AD worsened by stroke (AD+CVD). This problem was minimized in controlled clinical trials of VaD by excluding patients with a prior diagnosis of AD, those with pre-existing memory loss before the index stroke, and those with amnestic MCI. We propose a definition of dementia in VaD based on presence of abnormal executive control function, severe enough to interfere with social or occupational functioning. Vascular cognitive disorder (VCD): This term, proposed by Sachdev [P. Sachdev, Vascular cognitive disorder. Int J Geriat Psychiatry 14 (1999)402-403.] would become the global diagnostic category for cognitive impairment of vascular origin, ranging from VCI to VaD. It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This category explicitly excludes isolated cognitive dysfunctions such as those mentioned above.  相似文献   

14.
Vascular dementia   总被引:8,自引:0,他引:8  
Vascular dementia (VaD) is a term used to describe a particular constellation of cognitive and functional impairment, and is now generally seen as a subset of the larger syndrome of vascular cognitive impairment (VCI). The latter is seen as cognitive impairment in the face of cerebrovascular disease. VCI can be classified clinically by whether patients meet criteria for dementia, and whether the syndrome is distinct or overlaps with primary neurodegenerative diseases, such as Alzheimer's disease. This clinical classification can be further classified by neuroimaging, with subgroups that show cortical infarction, subcortical infarction and white matter changes, each alone or in combination. Understood in this way, VCI is likely the most common form of cognitive impairment in the population. Attempts to treat VaD had varying degrees of success, but it now appears that many forms of VCI might be preventable, especially with good control of vascular risk factors in middle age.  相似文献   

15.
Hypertension and stroke are highly prevalent risk factors for cognitive impairment and dementia. Alzheimer''s disease (AD) and vascular dementia (VaD) are the most common forms of dementia, and both conditions are preceded by a stage of cognitive impairment. Stroke is a major risk factor for the development of vascular cognitive impairment (VCI) and VaD; however, stroke may also predispose to AD. Hypertension is a major risk factor for stroke, thus linking hypertension to VCI and VaD, but hypertension is also an important risk factor for AD. Reducing these two major, but modifiable, risk factors—hypertension and stroke—could be a successful strategy for reducing the public health burden of cognitive impairment and dementia. Intake of long-chain omega-3 polyunsaturated fatty acids (LC-n3-FA) and the manipulation of factors involved in the renin–angiotensin system (e.g. angiotensin II or angiotensin-converting enzyme) have been shown to reduce the risk of developing hypertension and stroke, thereby reducing dementia risk. This paper will review the research conducted on the relationship between hypertension, stroke, and dementia and also on the impact of LC-n3-FA or antihypertensive treatments on risk factors for VCI, VaD, and AD.  相似文献   

16.
血管性认知障碍目前尚缺乏统一的影像诊断标准,近年来磁共振技术的发展提供了有助于血管性认知障碍早期诊断的神经影像学标志物。本文从弥散张量成像、磁共振波谱、磁共振磁敏感加权成像和功能磁共振成像多种磁共振模态对血管性认知障碍的影像特点进行综述。将多种模态的神经影像学检查方法联合运用有助于提高血管性认知障碍临床诊断的准确率,为进一步的治疗提供帮助。  相似文献   

17.
Abstract: The term vascular cognitive impairment (VCI) is now employed to capture the spectrum of illness and disability arising from impaired cognitive function of vascular origin. As such, it supplants the more narrowly focussed terms "Vascular dementia (VaD)" and "multi-infarct dementia". It is meant to include both those whose cognitive impairment is different from that assumed by the usual criteria for dementia. Traditionally, dementia criteria have been modelled on AD, a disorder with more characteristic neuropathological and clinical disease expression than is seen in VaD, which can occur in many forms. VCI is common, and is associated with many adverse outcomes, including worse cognition, institutionalization, and death.
One form of VCI is coincident AD and VaD, a category which, although it has been comparatively neglected, may be amongst the most common forms of dementia. Another common form of VCI has a predilection for subcortical ischemic lesions, and for a clinical presentation which reflects frontal and subcortical involvement.
At present, there is no specific treatment for VCI, although several agents appear to offer the hope of both treatment and prevention. Further research on the clinical, pathological and mechanistic underpinnings of this important syndrome is needed. For a long time, VaD has been recognized as the second most common cause of dementia.1,2) More recently, however, the concept of cognitive impairment in relation to cerebrovascular disease has been expanded. This paper will review the notion of "vascular cognitive impairment" (VCI) as it relates to clinical practice, and to our understanding of disease mechanisms in dementia and related disorders. It will propose that while the expanded concept has merit, within it are to be found distinct subgroups, including some of particular importance as targets for clinical trials of therapeutic and even preventive interventions.  相似文献   

18.
血管性认知障碍(vascular cognitive impairment,VCI)是一类由脑血管病危险因素或脑血管病引起的从轻度认知障碍到痴呆的综合征,脑血管病本身可以出现相应的脑影像学改变,这些病变和认知损伤的关系研究结论尚不统一。VCI的结构影像学研究主要采用结构磁共振成像(magnetic resonance imaging,MRI)、弥散加权成像和弥散张量成像技术,分别从卒中位置、大脑形态学及大脑白质结构等方面研究VCI引起的大脑微观结构变化及其与认知之间的关系。本文回顾了利用结构影像学对VCI的研究进展。  相似文献   

19.
The prevalence of vascular cognitive impairment (VCI) is likely to increase as the population ages and cardiovascular disease survival improves. We provide an overview of the definition and disease mechanisms of VCI and present a systematic literature review of the current evidence for the pharmacologic and nonpharmacologic therapies used to treat the VCI symptoms of cognitive dysfunction or to modify VCI through primary and secondary prevention. The Cochrane Database of Systematic Reviews was searched from 2005 to October 2010 using the keywords “vascular dementia” or “vascular cognitive impairment and therapy.” MEDLINE was searched for English-language articles published within the last 10 years using the combined Medical Subject Headings (MeSH) “therapeutics and dementia,” “vascular” or “vascular cognitive impairment.” Although cholinesterase inhibitors and memantine produce small cognitive improvements in patients with VCI, these drugs do not improve global clinical outcomes and have adverse effects and costs. Selective serotonin reuptake inhibitors and dihydropyridine calcium channel blockers may improve short-term cognitive function in patients with VCI. Anti-hypertensive therapy with an ACE inhibitor-based regimen and statins may prevent the major subtype of VCI known as poststroke cognitive decline. Clinical and effectiveness studies with long-term follow-up are needed to determine the benefits and risks of pharmacologic and nonpharmacologic therapies to prevent and treat VCI. Given its growing health, social, and economic burden, the prevention and treatment of VCI are critical priorities for clinical care and research.

Electronic supplementary material

The online version of this article (doi:10.1007/s13311-011-0047-z) contains supplementary material, which is available to authorized users.  相似文献   

20.
目的分析老年缺血性脑卒中后轻度血管性认知障碍(VCI)的影响因素。方法对患者一般资料、体格检查、认知评估及影像学资料进行收集与调查,并行单因素分析与Logistic回归分析。结果老年缺血性卒中后轻度VCI的发生与患者年龄、文化程度、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积有关;与性别、BMI、吸烟、饮酒等无明显相关。Logistic回归分析显示,文化程度为老年缺血性脑卒中后轻度VCI发生的保护因素,而年龄、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积是危险因素。结论老年缺血性脑卒中后轻度VCI发生的危险因素众多,临床上可进行针对性的早期干预。  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号