摘要
目的探讨老年血脑屏障通透性、缺血性脑白质高信号(white matter hyperintensity,WMH)严重程度与认知功能的关系。方法选择120例老年缺血性WMH患者为观察组,120例老年健康体检者为对照组。行MRI检查,比较两组血脑屏障通透性指标。根据Fazekas评分法将老年缺血性WMH患者分为三组:轻度(Fazekas评分为0~2分)、中度(Fazekas评分为3~4分)、重度(Fazekas评分为5~6分),比较不同WMH严重程度患者的血脑屏障通透性指标和认知功能水平,分析老年缺血性WMH患者血脑屏障通透性与WMH严重程度、认知功能的相关性。结果观察组脑白质正常区的渗透转运速率、渗透曲线下面积均显著高于对照组(P<0.05)。轻、中、重度WMH组的渗透转运速率、渗透曲线下面积比较,差异均有统计学意义(P<0.05),从高至低依次为重度WMH组、中度WMH组、轻度WMH组。轻、中、重度WMH组的MMSE评分、MoCA评分比较,差异均有统计学意义(P<0.05),从高至低依次为轻度WMH组、中度WMH组、重度WMH组。老年缺血性WMH患者渗透转运速率、渗透曲线下面积与其WMH严重程度均呈正相关(P<0.05),与其MMSE评分、MoCA评分均呈负相关(P<0.05)。结论老年缺血性WMH患者血脑屏障通透性随着WMH严重程度加重而增强,而血脑屏障通透性越强,认知功能损伤越严重。
Objective To explore the relationships between blood-brain barrier permeability and WMH severity and cognitive function in elderly patients with ischemic white matter hyperintensity(WMH).Methods One hundred and twenty elderly patients with ischemic WMH and 120 elderly healthy people were selected between January 2018 and January 2021,who were randomly divided into the observation group and control group.According to results of magnetic resonance imaging(MRI),the indexes of blood-brain barrier permeability were compared between the two groups.According to Fazekas scores,elderly patients with ischemic WMH were divided into three groups:mild(Fazekas score of 0-2),moderate(Fazekas score of 3-4)and severe(Fazekas score of 5-6).The cognitive function of these patients was evaluated.The blood-brain barrier permeability indexes and cognitive function indexes of patients with different levels of severity of WMH were compared.Results The osmotic transport rate and the area under the osmotic curve in normal areas of the white matter of the brain were significantly higher in the observation group than in the control group(P<0.05).The difference in the osmotic transport rate and areas under osmotic curves were statistically significant between mild,moderate and severe WMH groups(P<0.05),which were the highest in the severe WMH group.MMSE scores and MoCA scores were significantly different between the three groups(P<0.05),and they were the highest in the mild WMH group,followed by the moderate WMH group and severe WMH group.According to correlation analysis,the osmotic transport rate and the area under the osmotic curve of elderly patients with ischemic WMH were positively correlated with the severity of WMH(P<0.05),but were negatively correlated with MMSE scores and MoCA scores(P<0.05).Conclusions The permeability of blood-brain barriers increases with the severity of WMH.The stronger the permeability of blood-brain barriers is,the more serious the cognitive impairment becomes.
作者
许研杰
陈玮琪
杨志强
王锐
郭江涛
王伊龙
XU Yanjie;CHEN Weiqi;YANG Zhiqiang;WANG Rui;GUO Jiangtao;WANG Yilong(Department of Neurology,Beijing Longfu Hospital,Beijing 100000,China;Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China)
出处
《武警医学》
CAS
2021年第10期864-867,共4页
Medical Journal of the Chinese People's Armed Police Force
基金
北京市东城区优秀人才培养资助项目(2020-dchrcpyzz-40)
关键词
缺血性脑白质高信号
血脑屏障通透性
严重程度
认知功能
相关性
ischemic white matter hyperintensity
blood-brain barrier permeability
severity
cognitive function
correlation
