目的 研究脑血管储备功能(cerebrovascular reserve，CVR)对伴大脑中动脉(middle cerebral artery，MCA)狭窄的轻度血管性痴呆(vascular dementia，VD)患者预后的影响。方法 选择濮阳油田总医院2021年6月至2023年6月74例轻度VD患者为研究组，选择同期在本院体检的74例健康老年人为对照组进行回顾性研究，入组时、入组半年后，采用简易精神状态量表(mini-mental state examination，MMSE)评估两组认知障碍程度，采用经颅彩色多普勒超声(transcranial color doppler ultrasound，TCD)检测两组CVR指标，分析研究组CVR与MMSE分值的相关性。结果 入组时，研究组MMSE各项评分及总分(25。92±0。62)分均低于对照组(28。71±0。39)分，差异有统计学意义(P＜0。05);入组半年后组内比较，对照组MMSE各项评分及总分，差异无统计学意义(P＞0。05)，研究组MMSE各项评分及总分均降低，差异有统计学意义(P＜0。05);入组半年后组间比较，研究组MMSE各项评分及总分(22。31±0。24)分均低于对照组(28。63±0。38)分，差异有统计学意义(P＜0。05);入组时、入组半年后，研究组屏气指数(breath-holding index，BHI)及平均峰值流速(mean velocity，Vm)上升率分别是(0。83±0。24)、(18。67±4。28)％和(0。71±0。19)、(16。89±4。11)％，均低于对照组，搏动指数(pulse pressure index，PI)(1。02±0。32)和(1。18±0。43)均高于对照组，差异有统计学意义(P＜0。05);入组半年后，对照组PI、BHI及Vm上升率差异无统计学意义(P＞0。05)，研究组BHI及Vm上升率均显著降低，PI显著升高，差异无统计学意义(P＞0。05);Pearson相关性分析显示，PI与MMSE分值无明显相关性(P＞0。05)，BHI及Vm上升率与MMSE分值呈正相关(P＜0。05)。结论 CVR降低可能是VD发生及进展的重要因素，BHI、Vm上升率等CVR指标可作为评估伴MCA狭窄轻度VD患者预后的重要指标。
Effect of cerebrovascular reserve function on prognosis of mild vascular dementia with middle cerebral artery stenosis
Objective To investigate the impact of Cerebrovascular Reserve(CVR)on prognosis in patients with mild Vascular Dementia(VD)with Middle Cerebral Artery(MCA)stenosis.Methods Retrospective study,a total of 45 patients with mild VD in Puyang Oilfield General Hospital from June 2021 to June 2023 were selected as the study group,and a total of 74 healthy elderly people who underwent physical examination in hospital during the same period were selected as the control group.During enrollment and half a year after enrollment,Mini-mental State Examination was performed.Transcranial Color Doppler ultrasound(TCD)was used to detect the CVR index of the two groups,and the correlation between CVR and MMSE scores of the study group was analyzed.Results The scores and total scores of MMSE in the study group(25.92±0.62)were lower than those in the control group(28.71±0.39)(P＜0.05).There was no significant difference in the scores and total scores of MMSE in the control group(P＞0.05),while the scores and total scores of MMSE in the study group were decreased(P＜0.05).After six months of study,the scores and total scores of MMSE in the study group were lower than those in the control group(28.63±0.38)(P＜0.05).At the time of enrollment and six months after enrollment,the Breath-Holding Index(BHI)and mean velocity(Vm)of the study group were measured.The rising rates of Vm were(0.83±0.24),(18.67±4.28)％,(0.71±0.19)and(16.89±4.11)％,respectively,which were lower than those of the control group.PI(1.02±0.32)and(1.18±0.43)were higher than those in control group(P＜0.05).Six months after enrollment,there was no statistical signifi-cance in the increase rates of PI,BHI and Vm in the control group(P＞0.05),while the increase rates of BHI and Vm in the study group were significantly decreased,and PI was significantly increased(P＞0.05).Pearson correlation a-nalysis showed that PI had no significant correlation with MMSE score(P＞0.05),while BHI and Vm growth rates were positively correlated with MMSE score(P＜0.05).Conclusion The decrease of CVR may be an important factor for the occurrence and progression of VD.CVR indicators such as BHI and Vm increase rate can be used as important indi-cators to evaluate the prognosis of mild VD patients with MCA stenosis.
Vascular dementiaArterial stenosisCerebral vascular reserve function
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