脑小血管病总负荷与记忆力下降老年患者认知功能、脑萎缩及脑灌注的相关性

目的 探索脑小血管病（cerebral small vessel disease，CSVD）总负荷与记忆力下降老年患者认知功能、脑萎缩及脑灌注的关系。方法 回顾性纳入2015年12月-2017年12月同济医院神经内科门诊及记忆减退专病门诊主诉记忆力下降患者，收集一般资料及影像学信息，进行认知评估、CSVD总负荷评分、全脑及各脑叶脑萎缩评分，计算脑血流（cerebral blood flow，CBF）值。采用Spearman相关分析CSVD总负荷评分与认知功能、脑萎缩及CBF的关系。结果 共纳入200例，平均年龄69.16±9.44岁，男性99例（49.5%）。CSVD总负荷与MoCA评分呈负相关（r =-0.202，P =0.004）；与全脑（r =-0.234，P =0.001）、额叶（r =-0.252，P <0.001）、顶叶（r =-0.253，P <0.001）、枕叶（r =-0.224，P =0.001）CBF呈负相关；CSVD负荷与全脑（r =0.313，P <0.001）、额叶（r =0.393，P＜0.001）及顶叶（r =0.237，P =0.001）的脑萎缩评分呈正相关。结论 CSVD总负荷越高，认知功能越差、脑灌注越低、脑萎缩越严重。

Correlation between the Total Cerebral Small Vessel Disease Load and Cognitive Function,Brain Atrophy and Cerebral Perfusion in Patients with Memory Loss

Objective To investigate the correlation between the total cerebral small vessel disease (CSVD)load and cognitive function, brain atrophy and cerebral perfusion in patients with memory loss.Methods The outpatients with memory loss in the Department of Neurology and Memory Clinic ofTongji Hospital were retrospectively included in this study. The collected data included the generalinformation and imaging results, cognitive assessment (MoCA score), the total CSVD load, theatrophy score of the whole brain and each lode, and cerebral blood flow (CBF) of the whole brainand each lobe. Spearman correlation analysis was used to analyze the relationship between the totalCSVD load and cognitive function, brain atrophy and CBF.Results A total of 200 patients were included, with a mean age of 69.16±9.44 years old and 99 males(49.5%). The total CSVD load was negatively correlated with MoCA score (r =-0.202, P =0.004),and CBF of the whole brain (r =-0.234, P =0.001), frontal lobe (r =-0.252, P <0.001), parietal lobe(r =-0.253, P <0.001), and occipital lobe (r =-0.224, P =0.001). The total CSVD load was positivelycorrelated with the atrophy scores of the whole brain (r =0.313, P <0.001), frontal lobe (r =0.393,P<0.001) and parietal lobe (r =0.237, P =0.001).Conclusions The higher the CSVD load, the worse the cognitive function, the lower cerebralperfusion, and the more severe the brain atrophy.