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目的探讨脑白质疏松及脑血管危险因素在记忆损害型帕金森病(PD)轻度认知功能障碍患者中的影响。方法根据神经心理学测验结果,将102例PD患者分为记忆受损组30例、非记忆受损组35例和认知正常组37例,运用Scheltens视觉评定量表评估脑白质疏松程度,比较3组侧脑室旁、脑深部白质、基底节区、小脑幕下区脑白质疏松程度差异;分析脑血管危险因素在3组中的影响。运用多元线性回归分析脑白质疏松和脑血管危险因素等对记忆损害型PD轻度认知功能障碍患者的影响。结果记忆受损组额叶高信号、侧脑室旁白质高信号较认知正常组和非记忆受损组明显增高(P<0.05)。与认知正常组和非记忆受损组比较,记忆受损组TC明显升高[(5.87±0.81)mmol/L vs(3.86±1.10)mmol/L,(4.82±1.08)mmol/L],HDL-C明显降低[(1.17±0.24)mmol/L vs(1.26±0.53)mmol/L,(1.27±0.36)mmol/L,P<0.05]。多元线性回归分析显示,侧脑室旁脑白质高信号、TC与视觉再生呈负相关(β=-0.341,P=0.000;β=-0.212,P=0.030),教育程度与视觉再生呈正相关(β=0.201,P=0.038)。结论侧脑室旁脑白质疏松、高TC和高密度脂蛋白降低可能会导致PD-MCI患者的记忆受损。
Objective To investigate the effects of leukoaraiosis and cerebrovascular risk factors on patients with memory impairment Parkinson’s disease (mild cognitive dysfunction). Methods According to the results of neuropsychological tests, 102 patients with PD were divided into memory impairment group (n = 30), non-memory impairment group (n = 35) and cognition normal group (n = 37). The Scheltens visual assessment scale was used to evaluate the degree of leukoaraiosis. Three groups of lateral ventricle, brain deep white matter, basal ganglia, tentorium area of the brain white matter loose degree differences; analysis of cerebrovascular risk factors in the three groups. Using multivariate linear regression analysis of the impact of leucovorin and cerebrovascular risk factors on memory impairment patients with mild cognitive impairment. Results Compared with normal control group and non-memory impairment group, high signal of frontal lobe and high signal of left ventricular white matter in memory impaired group were significantly increased (P <0.05). Compared with the normal group and the non-memory group, the TC in the memory impairment group was significantly higher than that in the normal memory group [(5.87 ± 0.81) mmol / L vs (3.86 ± 1.10) mmol / L, [4.82 ± 1.08] mmol / L] HDL-C decreased significantly (1.17 ± 0.24 mmol / L vs 1.26 ± 0.53 mmol / L, 1.27 ± 0.36 mmol / L, P <0.05). Multivariate linear regression analysis showed that there was a negative correlation between TC and visual regeneration (β = -0.341, P = 0.000; β = -0.212, P = 0.030). There was a positive correlation between educational level and visual regeneration = 0.201, P = 0.038). CONCLUSIONS: Leukoaraiosis, high TC, and high density lipoprotein lowering in the lateral ventricles may result in impaired memory in PD-MCI patients.