高血压患者轻度认知功能障碍与大脑中动脉狭窄的关系及危险因素

目的 探讨高血压病患者合并无症状大脑中动脉狭窄(middle cerebral artery stenosis,MCAS)与轻度认知功能损障碍(mild cognitive impairment,MCI)的关系及相关危险因素。 方法 连续选取2012年4月-2013年4月在广州医学院荔湾医院行经颅多普勒彩色超声(transcranial Doppler,TCD)检查的住院或门诊高血压病患者210例,以简易精神状态检查量表(simple mental state examination,MMSE)和临床痴呆评定量表(clinical dementia rating scale,CDR)作为认知功能评价指标。 结果 ①210例高血压病患者中,28例患者合并MCI,182例患者不合并MCI,合并MCAS患者36例,MCAS患者中有MCI者9例,患病率25.0%;非MCAS患者中MCI者27例,患病率10.9%,2组患病率比较差异有统计学意义;②MCI组患者与非MCI组患者在年龄、收缩压、吸烟病史比较差异有统计学意义(P<0.05);③经逐步Logistic回归分析显示:大脑中动脉狭窄、收缩压、年龄是MCI的独立危险因素。 结论 高血压病患者合并大脑中动脉狭窄、收缩压、年龄增长是轻度认知功能障碍的独立危险因素,应积极筛查颅内血管狭窄情况,尽早干预,或可延缓认知功能障碍的发生。 

Correlation of mild cognitive impairment with middle cerebral artery stenosis and the risk factors in patients with hypertension

Objective To investigate the correlation of mild cognitive impairment (MCI) and asymptomatic middle cerebral artery (MCA) stenosis and the mild cognitive impairment risk factors in patients with hypertension. Methods Two hundred and ten patients with hypertension,who received transcranial color Doppler ultrasound (TCD) in our hospital between April,2012 and April,2013 were enrolled into this study.The simple mental state examination (MMSE) and clinical dementia rating scale (CDR) were used for cognitive function assessment. Results ①Among the 210 patients,28 patients were with MCI,36 patients with MCAS;9 of 36 cases of MCAS were with MCI,the prevalence was 25.0%;there were 27 cases of NMCAS patients with MCI,the prevalence was 10.9%,the difference in prevalence between the two groups was statistically significant.②Age,history of smoking and systolic blood pressure between the two groups was statistically significant.③The stepwise logistic regression analysis showed that:MCAS,systolic blood pressure and age were independent risk factors for MCI. Conclusion MCAS,systolic blood pressure and age are independent risk factors for MCI in patient with hypertension.The examination for intracranial vascular should be performed actively in patient with hypertension,and the early intervention may delay the occurrence of cognitive impairment.