缺血性脑血管病患者认知功能障碍的血管因素分析

目的探讨缺血性脑血管病患者血管因素与认知功能障碍关系。方法将60例缺血性脑血管病患者分为轻危组、中危组和高危组;应用经颅多普勒超声(TCD)检测脑血管血流动力学,蒙特利尔量表进行认知功能评定。结果高危组与低危组在视空间和执行功能、注意力、计算力、抽象概括能力、命名、记忆、时间定向方面有显著差异(P<0.05);中危组与低危组比较在视空间和执行功能、注意力、计算力、抽象概括能力、记忆方面有显著差异(P<0.05);视空间、命名、计算、语言、时间定向各方面中危组较高危组有显著差异(P<0.05)。高危组TCD异常比例明显高于轻危组(P<0.05),主要表现在大脑中动脉、椎动脉、基底动脉流速增快,频谱异常。中危组TCD结果异常比例明显高于轻危组,主要表现在各动脉流速增快;高危组较中危组在流速增快与频谱异常比例显著增高(P<0.05)。结论缺血性脑血管病患者随着危险因素增多,其认知功能障碍越显著,TCD各指标异常率也随之升高。

Analysis of vascular factors of cognitive impairment in patients with ischemic cerebrovascular disease

Objective To study the relations between vascular factors in patients with ischemic cerebrovascular disease and cognitive impairment.Methods 60 patients with ischemic cerebrovascular disease were divided into low-risk,midrange-risk,high-risk groups according to the scores of ESRS.The changes of cerebrovascular blood movement were measured by transcranial Doppler ultrasound(TCD) and their cognitive performance was assessed by Montreal cognitive assessment evaluation.Results(1) Compared with those of low-risk group,the scores of visual space and executive function,attention,calculation,ability of Abstract and epitome,naming,memory,time direction in high-risk group were significantly lower(P<0.05);the scores of visual space and executive,attention,calculation,ability of Abstract and epitome,memory in midrange-risk group were significantly lower(P<0.05).The scores in visual space and executive function,naming,calculation,language,time direction in high-risk group were significantly lower than those of midrange-risk group(P<0.05).(2) The proportion of abnormal TCD resulted in high-risk group was obviously higher than that of low-risk group,which was mainly manifested in the high velocity and anomaly spectrum of middle cerebral artery,vertebral artery,and basal artery(P<0.05).The proportion of abnormal TCD resulted in midrange-risk group was obviously higher than that of low-risk group,which was mainly manifested in the high velocity of every cerebral artery.The patients in high-risk group had significantly higher velocity and abnormal spectrum compared with those in midrange-risk group(P<0.05).Conclusions The patients with ischemic cerebrovascular disease have more cognitive impairment along with the more risk factors and the higher abnormal proportion of TCD.