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目的:研究老年高血压病患者认知功能障碍程度与头颅各部位磁共振弥散加权成像(MR-DWI)的表观弥散系数(ADC)值的关系,探讨轻度认知功能障碍(MCI)早期诊断和评估的参考指标。方法:入选60~80岁的老年高血压病患者40例进行现状调查。运用蒙特利尔认知量表(MoCA)和临床痴呆评定量表(CDR)对入选患者进行认知功能评定并分组:认知功能正常组8例、轻度认知功能障碍(MCI)组22例和痴呆组(VaD)10例。行MR-DWI检查,测算头颅各解剖部位ADC值。采用SPSS16.0软件进行数据统计分析。结果:①认知功能正常组和MCI组与VaD组比较,MoCA和CDR评分差异均有显著统计学意义(P<0.01)。②认知功能正常组和MCI组与VaD组比较,舒张压差异有统计学意义(P<0.01),收缩压差异无统计学意义(P>0.05)。③认知功能正常组和MCI组与VaD组比较,左侧半卵圆中心、右侧海马和左侧内囊ADC值差异有统计学意义(P<0.05)。④认知功能正常组与MCI组比较,右侧海马ADC值差异有统计学意义(P<0.0167);MCI组与VaD组比较,左侧内囊差异有统计学意义(P<0.0167)。结论:老年高血压病患者收缩压水平与认知功能相关。左侧半卵圆中心、右侧海马、左侧内囊区功能结构变化与认知功能密切相关。早期右侧海马区改变显著,后期左侧内囊区改变明显。
Objective: To investigate the relationship between the degree of cognitive impairment and the apparent diffusion coefficient (ADC) of MR-DWI in elderly patients with essential hypertension and to explore the relationship between the early cognitive impairment (MCI) Diagnostic and evaluation reference indicators. Methods: A total of 40 elderly hypertensive patients aged 60-80 years were enrolled in this study. Cognitive function was evaluated and divided into groups according to Montreal Cognitive Scale (MoCA) and Clinical Dementia Rating Scale (CDR). Eight patients with normal cognitive function, 22 patients with mild cognitive impairment (MCI) and Dementia group (VaD) in 10 cases. Line MR-DWI examination, calculate the ADC value of each anatomical part of the skull. Using SPSS16.0 software for statistical analysis. Results: ① There were significant differences in MoCA and CDR scores between normal cognitive function group and MCI group and VaD group (P <0.01). ②Compared with VaD group, there were significant differences in diastolic blood pressure in normal cognitive function group and MCI group (P <0.01), and there was no significant difference in systolic blood pressure (P> 0.05). (3) Compared with VaD group, there was significant difference in ADC value of the left semimajor center, right hippocampus and left internal capsule in cognitive function normal group and MCI group (P <0.05). ④Compared with MCI group, the ADC value of right hippocampus in normal cognitive function group was significantly different (P <0.0167). There was significant difference in the left internal capsule between MCI group and VaD group (P <0.0167). Conclusion: The systolic blood pressure in elderly patients with hypertension is related to cognitive function. Left hemisphere center, the right hippocampus, left inner capsule functional structure and cognitive function are closely related. Early right hippocampus changes significantly, late left internal capsule changed significantly.