首次前循环TIA后脑血流量降低与认知功能减退的关系

发布时间：2018-07-24 15:27

【摘要】：目的运用脑CT灌注成像技术评估首次TIA后认知功能减退是否与脑血流量变化有关。方法选择性回顾2009年8月至2014年8月在成都军区总医院神经内科住院的发病24 h内首次临床诊断为前循环TIA及认知量表评定正常的50例患者,发病1周内进行全脑CTPI检查,分别监测感兴趣区域脑血容量(cerebral blood volume,CBV)、脑血流量(cerebral blood flow,CBF)、平均通过时间(mean transit time,MTT)、达峰时间(time to peak,TTP);发病第4周进行认知量表评价,根据认知量表结果分为VCI组与对照组,比较2组患者早期CTPI灌注参数的差异,并将VCI组认知量表评分与灌注参数进行相关性分析。结果 VCI组与对照组在年龄、性别、血压、血脂、血糖、同型半胱氨酸、前循环TIA发作至入院平均时间及前循环TIA发作至完成CTPI的平均时间等方面结果相仿,基线水平无统计学差异;VCI组与对照组相比,VCI组CBF降低,MTT、TTP明显延长,差异有统计学意义(P0.05);2组患者CBV相仿,差异无统计学意义(P0.05);Spearman相关性分析显示Mo CA与VCI组MTT值负相关(r=-0.51,P=0.009)。结论 TIA发生后脑血流灌注降低与认知功能下降的发生有一定相关性,提示CTPI对前循环TIA后VCI早期预警有一定诊断价值。
[Abstract]:Objective to evaluate whether cognitive impairment is associated with cerebral blood flow (CBF) after first TIA using cerebral CT perfusion imaging. Methods from August 2009 to August 2014, 50 patients who were hospitalized in Department of Neurology, Chengdu military region General Hospital for the first time in 24 hours were assessed as normal by anterior circulation TIA and cognitive scale. The whole brain CTPI was performed within one week of onset. The cerebral blood volume (cerebral blood), cerebral blood flow (cerebral blood flow-CBF), mean (mean transit time (mean transit time), peak time (time to peak-tp) were monitored in the region of interest respectively, and the cognitive scales were evaluated at the 4th week of the disease, and were divided into VCI group and control group according to the results of the cognitive scale. The differences of early CTPI perfusion parameters between the two groups were compared, and the correlation between the cognitive scale scores and perfusion parameters in VCI group was analyzed. Results the results of age, sex, blood pressure, blood lipid, blood glucose, homocysteine, mean time from onset to admission of TIA in anterior circulation and average time from onset of TIA to completion of CTPI in VCI group were similar to those in control group. There was no statistical difference in baseline level. The CBF of VCI group was significantly longer than that of control group. The difference was statistically significant (P0.05). There was no significant difference in CBV between two groups (P0.05). The Spearman correlation analysis showed that the MTT value of VCI group was negatively correlated with that of Mo CA group (r-0.51g, P 0.009). Conclusion the decrease of cerebral blood flow perfusion after TIA is associated with cognitive impairment, which suggests that CTPI is valuable in early warning of VCI after anterior circulation TIA.
【作者单位】：第三军医大学研究生管理大队;成都军区总医院神经内科;
【基金】：成都军区医学科学技术研究“十二五”计划研究项目(C12045) 成都军区总医院重点研究项目(2013YG-A006)~~
【分类号】：R749.1

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