颈动脉彩超检查指标与脑白质病变及认知功能改变的相关性

  目的  探讨双侧颈动脉内膜-中层厚度、斑块的数量和狭窄程度与脑白质病变（WML）及认知功能改变的相关性。  方法  纳入2020年1月~2021年1月就诊于连云港市第一人民医院神经内科的146例患者作为研究对象，其中73例WML患者作为WML组，73例非WML患者作为非WML组，采取前瞻性观察性队列研究方法，对患者进行认知功能评分、颈部血管彩超、头颅MRI的WML程度评分，分析颈动脉病变各指标与WML程度量表评分、认知功能量表评分的关联性，探索颈动脉病变与WML和认知功能障碍的关系。  结果  WML组患者颈动脉内膜-中层厚度、斑块的数量总分和狭窄程度总分高于非WML组（1.97± 0.83 mm vs 0.87±0.12 mm，6±3.28分vs 4±1.96分，4.83±1.17分vs 2.89±1.05分，P < 0.05）；WML组患者MoCA量表评分高于非WML组（18±6.82分vs 10±5.67分，P < 0.01）。对WML组患者颈动脉彩超指标与WML程度评分的相关性分析发现，WML组患者颈动脉内膜-中层厚度（r=0.828，P=0.020）、狭窄程度（r=0.897，P=0.010）和WML程度评分相关；而斑块的数量和WML程度评分之间无相关关系（P > 0.05）。对WML组患者颈动脉彩超指标与MoCA评分的相关性分析发现，WML组患者颈动脉内膜-中层厚度（r=-0.793，P=0.020）、狭窄程度（r=-0.873，P=0.010）和MoCA量表评分相关，而斑块的数量和MoCA评分不相关（P > 0.05）。WML组患者MoCA量表评分与WML程度评分呈负相关（r=-0.837，P < 0.01）。  结论  颈部血管彩超的颈动脉内膜-中层厚度以及血管狭窄程度与WML程度、认知功能障碍相关，WML程度与认知功能障碍程度呈负相关，颈动脉彩超对于临床诊断和预测WML和认知功能障碍具有一定的指导作用。 

Correlation of carotid artery color Doppler ultrasound examination indexes,white matter lesions and cognitive function changes

  Objective  To investigate the correlation between the intima-media thickness of the bilateral carotid arteries, the number of plaques and the degree of stenosis, white matter lesions (WHL) and cognitive function changes.  Methods  A total of 146 patients in our hospital from January 2020 to January 2021 were selected. Among the patients, 73 patients with WHL were treated as WHL group, and 73 non-WHL patients were treated as non-WHL group. For patients with WHL, a prospective observational cohort study method was performed. Cognitive function scores, cervical vascular color Doppler ultrasound, and head MRI WHL were scored for each case, and various indicators of carotid artery lesions and WHL scales were analyzed. The correlation between score and cognitive function scale score, to explore the relationship between carotid artery disease and WHL and cognitive dysfunction.  Results  The intima-media thickness, total number of plaque points and total stenosis degree points in WML group were higher than those in non-WML group (1.97±0.83 mm vs 0.87±0.12 mm, 6±3.28 vs 4±1.96, 4.83±1.17 vs 2.89±1.05, P < 0.05). The MoCA score of WML group was significantly higher than that of non-WML group (18±6.82 vs 10±5.67, P < 0.01). The correlation analysis of carotid artery color doppler ultrasound index and WML degree score showed that carotid intima-media thickness (r=0.828, P=0.020), stenosis degree (r=0.897, P=0.010) and WML degree score were correlated. The number of plaques and the WML degree showed no correlation (P > 0.05). The correlation analysis of carotid artery color doppler ultrasound index and MoCA score in the WML group showed that intima-media thickness (r=-0.793, P=0.020), stenosis degree (r=-0.873, P=0.010) and MoCA scale score were correlated in the WML group. There was no correlation between plaque number and MoCA score (P > 0.05). The correlation analysis of the MoCA scale score and the WHL degree score of the WHL group showed that the MoCA scale score and the WHL degree score of the WHL group were negatively correlated (r=-0.837, P < 0.01).  Conclusion  The carotid intima-media thickness and the degree of vascular stenosis of cervical vascular color Doppler ultrasound are related to the degree of WHL and cognitive dysfunction. The degree of WHL is negatively correlated with the degree of cognitive dysfunction. Carotid artery color Doppler ultrasound is useful for clinical diagnosis. And predict WML and cognitive dysfunction has a certain guiding role.