老年人脑小血管病与轻度认知功能障碍的相关性OACSTPCD
Association between cerebral small vessel disease and mild cognitive impairment in the elderly
目的 探讨老年人群中脑小血管病(CSVD)与轻度认知功能障碍(MCI)的相关性.方法 选取2022年3月—2023年2月诊断MCI的老年患者109例(实验组)和认知功能正常的健康对照者89例(对照组),收集所有受试者的人口统计学和一般临床资料,并根据头部MRI表现,评估CSVD的发生情况.比较两组间基线资料、一般临床资料及CSVD表现的差异.应用有序多分类Logistic回归模型确定老年人群MCI的独立影响因素.结果 与实验组比较,对照组受教育年限较长,经济状况较好,社会活动参与度较高,饮酒率较低,差异有统计学意义(P均<0.05).实验组及对照组中,分别有90例(82.57%)和62例(69.66%)受试者出现不同CSVD表型.实验组无症状性腔隙性脑梗死(LI)及中重度脑白质高信号(WMH)的检出率均高于对照组(P均<0.05),而中重度血管周围腔隙扩大(EPVS)及脑微出血(CMB)检出率间差异无统计学意义(P均>0.05).两组间CSVD总负荷评分及CSVD总负荷程度差异均有统计学意义(P均<0.05).Logistic回归分析显示:受教育年限、社会活动参与度、CSVD检出率、中重度WMHs、CSVD总负荷评分、CSVD总负荷程度是老年人MCI的独立影响因素.结论 老年MCI患者的CSVD检出率增高,尤其是LI及中重度WMH.CSVD总负荷评分及CSVD总负荷程度均与老年人MCI独立相关.
Objective To investigate the association between cerebral small vessel disease(CSVD)and mild cogni-tive impairment(MCI)in the elderly.Methods A total of 109 elderly patients who were diagnosed with MCI from March 2022 to February 2023 were enrolled as experimental group,and 89 healthy controls with normal cognitive function were en-rolled as control group.Demographic data and general clinical data were collected from all subjects,and the onset of CSVD was evaluated based on cranial MRI findings.The two groups were compared in terms of baseline data,general clinical data,and CSVD manifestations.The ordered multi-classification logistic regression model was used to identify the independent in-fluencing factors for MCI in the elderly.Results There were 109 patients with MCI and 89 controls in this study.Compared with the experimental group,the control group had significantly longer education years,a significantly better economic sta-tus,a significantly higher degree of participation in social activities,and a significantly lower alcohol consumption rate(P<0.05).There were 90 subjects(82.57%)in the experimental group and 62(69.66%)in the control group who had differ-ent CSVD phenotypes.The experimental group had significantly higher detection rates of LI and moderate-to-severe WMH than the control group(P<0.05),while there were no significant differences between the two groups in the detection rates of moderate-to-severe EPVS and CMB(P>0.05).There were significant differences between the two groups in the total load score of CSVD and the total load degree of CSVD(P<0.05).The logistic regression analysis showed that education years,participation in social activities,detection rate of CSVD,moderate-to-severe WMH,total load score of CSVD,and total load degree of CSVD were independent influencing factors for MCI in the elderly.Conclusion There is an increase in the detec-tion rate of CSVD in the elderly patients with MCI,especially LI and moderate-to-severe WMH.The total load score of CSVD and the total load degree of CSVD are independently associated with MCI in the elderly.
陆强彬;柏燕燕;朱祖福;孔玉;张慧萍
南通大学附属江阴医院神经内科,江苏 江阴 214400
临床医学
脑小血管疾病轻度认知功能障碍老年人影响因素
Cerebral small vessel diseaseMild cognitive impairmentElderlyInfluencing factors
《中风与神经疾病杂志》 2024 (004)
329-335 / 7
江阴市科技局(JY0603A021014210021)
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