摘要
目的探讨不同部位和严重程度扩大血管周围间隙(EPVS)与老年男性认知功能相关性。方法选取2010年1月~2016年5月大连大学附属新华医院与大连大学附属中山医院体检门诊的80名男性患者,进行MRI扫描和全面的认知测试。对EPVS的严重程度进行视觉分级,根据大小分为0~3级,根据数目进行评分0~4分。依据EPVS病变部位分为无EPVS、基底节区EPVS、半卵圆中心(包括皮质下白质)EPVS、海马区EPVS及混合部位EPVS。采用蒙特利尔认知评估量表(MoCA)分析不同部位和严重程度EPVS的认知功能差异。结果 EPVS数目评分与MoCA认知评估总分呈负相关(r=-0.630,P<0.05)。EPVS不同分级MoCA各项评分比较,各级别在总评分和分项评分有整体差异(P<0.05)。1级与0级相比,注意力与计算力评分降低(P<0.05);2级与0级相比,MoCA总分、视空间与执行能力、注意力与计算力、延迟记忆评分降低(P<0.05)。2级与1级相比,MoCA总分、视空间与执行能力、延迟记忆评分降低(P<0.05);3级与2级相比,定向力评分差异无统计学意义(P>0.05),3级与0级、1级相比,MoCA总分及其他各项评分降低(P<0.05)。不同部位EPVS的总评分和分项评分均低于无EPVS(P<0.05)。但不同部位EPVS间两两比较,差异无统计学意义(P>0.05)。结论认知功能与EPVS程度相关,EPVS在视空间与执行功能、延迟回忆方面存在明显的认知损害。EPVS可能为认知功能障碍的影像学检查之一。
Objective To explore the relationship between Enlargement of perivascular space （EPVS） in different sites and severity and cognitive function in the elderly men. Methods From January 2010 to May 2016, 80 elderly men at Dalian University Affiliated Xinhua Hospital and Dalian University Affiliated Zhongshan hospital were selected, which were accepted MRI scan and a comprehensive cognitive test. The severity of EPVS based on visual grading was divided into grade 0 to grade 3 according to the size of EPVS and rated 0 to 4 points according to the number of EPVS. Ac- cording to the lesions location of EPVS, EPVS were divided into non EPVS, basal ganglia EPVS, semioval center （in- cluding the subcortical white matter） EPVS, hippocampus EPVS and mixed legions EPVS. The difference of cognitive function between different sites and severity of EPVS were analyzed by Montreal cognitive assessment scale （MoCA）. Results The EPVS score was negatively correlated with the total score of MoCA （r=-0.630, P 〈 0.05）. The total score and subentry scores of MoCA had significant difference in different grades （P 〈 0.05）. The attention and calculation score of grade 1 was decreased than that of grade 0 （P 〈 0.05）. The MoCA total score, visual space and executive abili- ty score, attention and calculation score and delaved memory score of grade 2 were decreased than those of grade 0 （P 〈 0.05）. The MoCA total score, visual space and executive ability score and delayed memory score of grade 2 were de- creased than those of grade 1 （P 〈 0.05）. There was no difference in orientation score between grade 3 and grade 2 （P 〉 0.05）. The total score and subproject score of grade 3 were decreased than those of grade 0 or grade 1 （P 〈 0.05）. The total score and subentry scores of MoCA in non EPVS were decreased than those of different location EPVS （P 〈 0.05）, while there were no differences comparison between any two means in the different location EPVS （P 〉 0.05）. Conclusion Cognitive functien is related to the degree of EPVS. The elderly men with EPVS have obvious damage in cognitive function including spatial ability, executive function and delayed recall. EPVS may be one of the imaging methods for Cognitive dysfunction.
出处
《中国医药导报》
CAS
2017年第11期73-75,82,F0003,共5页
China Medical Herald
关键词
扩大血管周围间隙
认知功能
蒙特利尔认知评估
Enlarged perivascular spaces
Cognitiveimpairment
Montreal cognitive assessment
