临床神经病学杂志2024，Vol.37Issue(4)：241-249,9.
脑白质病变患者血压变异性、脑白质血流量与认知功能障碍的关系
Relationship between blood pressure variability,white matter blood flow and cognitive dysfunction in patients with white matter lesions
摘要
Abstract
Objective To explore the relationship between blood pressure variability(BPV),white matter lesions(WMLs),regional cerebral blood flow(rCBF)and cognitive function.Methods The degree of WMLs was assessed by Fazekas scale.rCBF was detected by brain perfusion imaging.Twenty-four hour ambulatory blood pressure monitoring was used to calculate the blood pressure coefficient of variation(CV)to measure BPV.Cognitive function was assessed by Montreal cognitive assessment(MoCA).Results Multivariate Logistic regression analysis showed that compared with those in 24 h systolic blood pressure CV Q1 group,mean white matter blood flow(MWCBF)in Q3 group and Q4 group were significantly decreased(OR=5.63,95%CI:1.31-24.14,OR=9.70,95%CI:2.23-42.17),the risk of moderate to severe cognitive impairment was significantly increased(OR=5.37,95%CI:1.24-23.21;OR=10.44,95%CI:2.39-45.65);the risk of severe WMLs in the Q4 group was significantly increased(OR=9.61,95%CI:2.00-46.26).Person correlation analysis showed that mean diurnal systolic blood pressure(MDSBP),mean nocturnal systolic blood pressure(MNSBP),mean diurnal diastolic blood pressure(MDDBP)and mean nocturnal diastolic blood pressure(MNDBP)were negatively correlated MWCBF(all P<0.01).MoCA score was positively correlated with MWCBF(P<0.01),and negatively correlated with daytime systolic blood pressure coefficient of variation(dSBPCV),nighttime systolic blood pressure coefficient of variation(nSBPCV),daytime diastolic blood pressure coefficient of variation(dDBPCV),nighttime diastolic blood pressure coefficient of variation(nDBPCV)and Fazekas score(all P<0.01).Fazekas score was positively correlated with dSBPCV,nSBPCV,dDBPCV and nDBPCV(all P<0.01),and negatively correlated with MWCBF(P<0.01).Conclusions High BPV is an independent risk factor for cognitive impairment in WMLs patients.Lower MWCBF is associated with lower MoCA score and higher BPV.关键词
高血压/血压变异性/脑白质病变/认知功能障碍/脑血流量Key words
high blood pressure/blood pressure variability/white matter lesions/cognitive dysfunction/cerebral blood flow分类
医药卫生引用本文复制引用
谭沙一君,刘逊,尹瑾,张俊霞,何明利..脑白质病变患者血压变异性、脑白质血流量与认知功能障碍的关系[J].临床神经病学杂志,2024,37(4):241-249,9.基金项目
国家自然科学基金项目(81970348) （81970348）
