慢性脑供血不足患者认知功能障碍与脑血流的相关性分析

目的探讨慢性脑供血不足（CCCI）患者认知功能障碍与脑血流变化的关系,为阐明该病的发生机制和防治提供依据。方法对符合CCCI诊断标准的25例患者进行前瞻性研究,利用64层螺旋CT行CTPI检查,分别在脑干、小脑、豆状核、丘脑、额、颞、顶、枕叶、放射冠区、半卵圆中心选取感兴趣区（ROI）,以年龄、性别相当的10例正常志愿者作为对照组。比较病例组与对照组不同脑区域之间CBF值和MoCA评分。结果病例组各个脑区域ROI的CBF与对照组比较差异均有统计学意义（P〈0.05）,其中额叶、颞叶及深部白质ROI的CBF下降更加明显（t值分别为6.78、3.66和8.93;P〈0.01）;Mo-CA评分与对照组比较差异有统计学意义（t=7.60,P〈0.01）,且视空间与执行功能、记忆评分比较差异亦有统计学意义（P〈0.01）。结论 CCCI患者认知功能障碍可能与这些区域脑血流量显著下降有关。

Preliminary study of the relationships of cerebral blood flow changes and cognitive impairment in patients with chronic cerebral circulation insufficiency

Objective To investigate the relationships of cerebral blood flow changes and cognitive impairment in patients with chronic cerebral circulation insufficiency（CCCI）.Methods Twenty-five cases conforming to the diagnostic criteria of CCCI were prospectively included in the study and ten volunteers with matched age and gender as control.The MS-CTPI examinations were performed on 64-slices CT and chose the followings as the observing regions of interest（ROI）： brainstem,cerebellar,lenticulate,thalamus,frontal,temporal,parietal,occipital,corona radiate,central semi-oval.The CBF values and MoCA scores were compared in the above-mentioned areas between the two groups.Results The CBF values of all observed areas in cases group showed statistically significant difference from control group（P0.05） with highly significant decrease for CBF in frontal,temporal lobe and deep white matter（DWM）（t=6.78,3.66 and 8.93;P0.01）.MoCA scores values in cases group were significantly lower than those of control group（t=7.60,P0.01）as well as visual space and executive function and memory.Conclusion Cognitive impairment in CCCI patients may attribute to the decrease of CBF in the related regions especially notable in frontal temporal lobe and DWM.CTPI may provide quantitative evidence for diagnosis and treatment.