脑小血管病患者类淋巴系统功能与认知障碍关系的研究
Study on the relationship between glymphatic system function and cognitive impairment in patients with cerebral small vessel disease
钟琴 1李惠 1李友 1张树桐 1王翔 1谢元亮 1李翔 1黄增发1
作者信息
- 1. 430014 武汉,武汉市中心医院放射科
- 折叠
摘要
目的:探讨脑小血管病(CSVD)患者类淋巴系统功能与认知功能的关系.方法:前瞻性收集70例CSVD患者和37例健康对照(HCs),采用基于扩散张量成像(DTI)的髓静脉周围间隙扩散系数(ALPS指数)来评估类淋巴功能.比较HCs组、CSVD认知正常(CSVD-CN)组、CSVD认知障碍(CSVD-CI)组间的ALPS指数差异.采用Spearman相关分析和Logistic回归分析来评估CSVD患者ALPS指数与认知功能评分间的关系.结果:CSVD-CI组的左侧ALPS 指数、右侧ALPS指数和双侧平均ALPS指数均显著低于CSVD-CN组和HCs组(P＜0.017,Bonferroni校正).CSVD患者双侧平均ALPS指数与MoCA评分(ρ=0.583,P＜0.001)、视空间与执行功能(ρ=0.285,P=0.017)、注意力(ρ=0.301,P=0.011)、延迟回忆(ρ=0.697,P＜0.001)和定向力(ρ=0.329,P=0.006)呈正相关.较低的双侧平均ALPS指数可显著增加CSVD患者认知障碍的风险,且是CSVD患者整体认知功能障碍的独立危险因素,校正混杂因素后的风险比值比(OR)为3.674[(95％CI:1.017～13.273),P=0.047].结论:CSVD患者存在类淋巴系统功能障碍,整体类淋巴功能下降是CSVD患者整体认知功能障碍的独立危险因素.
Abstract
Objective:To explore the relationship between glymphatic system function and cog-nitive function in patients with cerebral small vessel disease(CSVD).Methods:Seventy patients with CSVD and 37 healthy controls(HCs)were prospectively collected.Diffusion tensor imaging(DTI)a-nalysis along the perivascular space(ALPS index)was applied to characterize glymphatic function.ALPS index among the HCs group,CSVD-normal cognition group(CSVD-CN),and CSVD-impaired cognition group(CSVD-CI)were compared.Spearman correlation analysis and logistic regression a-nalysis were used to evaluate the relationship between ALPS index and cognitive function in patients with CSVD.Results:The left ALPS index,right ALPS index,and bilateral average ALPS index of the CSVD-CI group were significantly lower than those of the CSVD-CN group and HCs group(P＜0.017,bonferroni correction).The bilateral average ALPS index of CSVD patients was positively corre-lated with MoCA score(ρ=0.583,P＜0.001),visual space and executive function(ρ=0.285,P=0.017),attention(ρ=0.301,P=0.011),delayed memory(ρ=0.697,P＜0.001),and directional ability(ρ=0.329,P=0.006).The lower bilateral average ALPS index could significantly increase the risk of cognitive impairment,and it was an independent risk factor for overall cognitive impairment in CSVD patients[after adjusting for confounding factors,OR=3.674,95％CI(1.017～13.273),P=0.047].Conclusion:Patients with CSVD had glymphatic dysfunction.The overall declined glymphatic function is an independent risk factor for cognitive impairment in patients with CSVD.
关键词
脑小血管病/类淋巴系统/扩散张量成像/认知障碍Key words
Cerebral small vascular disease/Glymphatic system/Diffusion tensor imaging/Cognitive impairment引用本文复制引用
基金项目
武汉市科技局项目(2022020801020545)
出版年
2024
NETL
NSTL
万方数据