2019 年第 6 期 第 14 卷

肱-踝脉搏波传导速度与中老年患者脑白质病变的相关性研究

Association between brachial-ankle pulse wave velocity and white matter lesions in middle-aged and old patients

作者：薛嫱胡风云贾文辉王锐张爱菊

英文作者：

单位：030012太原，山西医科大学附属人民医院山西省人民医院神经内科［薛嫱（山西医科大学2016级神经病学专业在读硕士研究生）、胡风云、贾文辉、张爱菊］；044000山西省运城市中心医院神经内科（王锐）

英文单位：

关键词：脑白质病变；肱-踝脉搏波速度；认知功能

英文关键词：

• 摘要：

• 【摘要】探讨肱-踝脉搏波传导速度（baPWV）与中老年患者脑白质病变（WML）的相关性。方法    回顾性选取2018年4—10月山西医科大学附属人民医院神经内科住院患者141例。使用Fazekas量表评分将患者分为0级（0分）、1级（1～2分）、2级（3～4分）、3级（5～6分）。比较各级WML患者一般资料和baPWV、蒙特利尔认知量表(MoCA)评分，分析baPWV与MoCA评分的相关性和影响WML程度的相关因素。结果    3级WML患者年龄和高血压、糖尿病、冠状动脉粥样硬化性心脏病、吸烟、饮酒比例及总胆固醇、低密度脂蛋白胆固醇、高敏C反应蛋白水平均明显高于0级WML患者，高密度脂蛋白胆固醇水平明显低于0级WML患者，差异均有统计学意义（均P＜0.05）。1、2、3级WML患者baPWV均明显高于0级WML患者［（15.4±2.4）、（16.3±2.3）、（17.4±2.9）m/s比（13.2±1.9）m/s］，差异均有统计学意义（均P＜0.05）。3级WML患者MoCA评分中抽象、视空间与执行功能、延迟回忆评分及总分均明显低于0、1、2级 WML患者，差异均有统计学意义（均P＜0.05）。baPWV与MoCA评分呈显著负相关(r=-0.794，P＜0.001)。Logistic回归分析结果显示，体重指数、baPWV、糖尿病、吸烟、年龄是影响WML程度的独立危险因素（均P＜0.05）。结论    baPWV是中老年患者脑白质病变的危险因素，与脑白质病变引起的认知功能损害明显相关。

• 【Abstract】To investigate the association between brachial-ankle pulse wave velocity（baPWV） and white matter lesions（WML） in middle-aged and old patients. Methods    Clinical data of 141 patients admitted to Department of Neurology, People′s Hospital Affiliated to Shanxi Medical University from April to October 2018 were retrospectively analyzed. Fazekas scale was used to classify the patients into grade 0(0 points), grade 1(1-2 points), grade 2(3-4 points) and grade 3(5-6 points). Correlation between baPWV and score of Montreal Cognitive Assessment(MoCA) was analyzed. Influence factors of WML were analyzed. Results    Age, rates of hypertension, diabetes, coronary heart disease, smoking, alcohol consumption, levels of total cholesterol, low-density lipoprotein cholesterol and high-sensitive C-reactive protein in grade 3 WML patients were significantly higher while high-density lipoprotein cholesterol level was significantly lower than those in grade 0 WML patients（all P＜0.05）. BaPWV in grade 1, 2, 3 WML patients were significantly higher than that in grade 0 WML patients［（15.4±2.4）,（16.3±2.3）,（17.4±2.9）m/s vs （13.2±1.9）m/s］ (all P＜0.05). Scores of abstraction, visual space and executive function, delayed recall and the total MoCA score in grade 3 WML patients were significantly lower than those in grade 0, 1, 2 WML patients(all P＜0.05). MoCA score was negatively correlated with baPWV(r=-0.794, P＜0.001). Logistic regression showed that body mass index, baPWV, diabetes, smoking and age were independent risk factors of WML(all P＜0.05). Conclusions    BaPWV is a risk factor of WML in middle-aged and old patients. There is a significant relation between baPWV and cognitive disorder caused by WML.