文章摘要
蒙陶莎,李先锋,韦琳,陈德耀,范利齐.原发性高血压患者脑血管反应性改变及与认知功能减退的关系[J].中国临床保健杂志,2018,21(5):636-639.
原发性高血压患者脑血管反应性改变及与认知功能减退的关系
Relationship between changes of cerebrovascular reactivity and cognitive decline in patients with essential hypertension
投稿时间:2017-06-19  
DOI:10.3969/J.issn.1672-6790.2018.05.018
中文关键词: 高血压  脑血管损伤  认知功能障碍
英文关键词: Hypertension  Cerebrovascular trauma  Cognitive dysfunction 〖FL
基金项目:
作者单位E-mail
蒙陶莎 广西南宁市第一人民医院神经内科二区,530022 176401623@qq.com 
李先锋 广西南宁市第一人民医院神经内科二区,530022 lxianf@sina.com 
韦琳 广西南宁市第一人民医院神经内科二区,530022  
陈德耀 广西南宁市第一人民医院神经内科二区,530022  
范利齐 广西南宁市第一人民医院神经内科二区,530022  
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中文摘要:
      目的 研究原发性高血压患者脑血管反应性(CVR)改变及与认知功能减退的关系。方法 选取90例原发性高血压患者为研究组,以同期门诊体检的健康人员45例为对照组,以蒙特利尔认知评估量表(MoCA)评分≤25分为认知功能减退标准,将研究组分为认知功能减退组与认知功能正常组,比较研究组与对照组双侧大脑中动脉血流平均流速(Vm)、脉动指数(PI)、屏气指数(BHI)、加压后肱动脉内径(D1)、动脉弹性系数(Ep)及MoCA评分,分析Vm、PI、BHI、D1、Ep与MoCA的相关性,并分析影响认知功能的危险因素。结果研究组Vm(51.92±6.10)sm/s、BHI(1.26±0.75)、D1(3.78±0.21)mm、Ep(116.52±2.78)kPa、MoCA评分(23.45±1.44)分与对照组比较明显较低(P均<0.05),而其PI(1.49±0.24)高于对照组(P<0.05);相关分析显示原发性高血压患者Vm、BHI、D1、Ep与MoCA评分呈正相关,而PI与MoCA评分呈负相关(P<0.05);认知功能减退组年龄、高血压病程、收缩压、舒张压及CVR减少率91.40%高于认知功能正常组(P<0.05);logistic回归分析显示年龄、高血压病程及BHI为导致原发性高血压患者发生认知功能减退的独立危险因素(P<0.05)。结论 原发性高血压患者存在Vm、BHI、D1、Ep偏低而PI增加特点,脑血管反应性改变所致的BHI降低及年龄、高血压可能加速认知功能减退。
英文摘要:
      Objective To study the relationship between changes of cerebrovascular reactivity (CVR) and cognitive decline in patients with essential hypertension. Methods 90 patients with essential hypertension were selected as the study group,and 45 healthy persons were selected as control group in the same period.With the score of Montreal cognitive assessment scale (MoCA) ≤ 25 points as the standard of cognitive decline,the study group were divided into the cognitive decline group and the normal cognitive function group.The mean blood flow velocity (Vm) of bilateral middle cerebral arteries,pulsatility index (PI),breath-holding index (BHI),brachial artery diameter(D1) after compression,arterial elasticity coefficient (Ep) and MoCA scores were compared between the study group and the control group.The correlation between Vm,PI,BHI,D1,Ep and MoCA,and the risk factors of cognitive function were analyzed. Results Vm,BHI,D1,Ep and MoCA score of the study group were significantly lower than those of the control group (P<0.05),while PI was higher than that of the control group (P<0.05).Vm,BHI,D1 and Ep were positively correlated with MoCA score in patients with essential hypertension,but PI was negatively correlated with MoCA score (P<0.05).Age,course of hypertension,SBP,DBP and CVR reduction rate of the cognitive decline group were higher than those of normal cognitive function group (P<0.05).logistic regression analysis showed that age,course of hypertension and BHI were independent risk factors for cognitive decline in patients with essential hypertension (P<0.05). Conclusion In patients with essential hypertension,Vm,BHI,D1 and Ep were decreased while PI was increased.Changes of cerebrovascular reactivity can decrease BHI,and age,and hypertension may accelerate cognitive decline.
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