發(fā)布時(shí)間：2018-07-24 15:27

【摘要】：目的運(yùn)用腦CT灌注成像技術(shù)評(píng)估首次TIA后認(rèn)知功能減退是否與腦血流量變化有關(guān)。方法選擇性回顧2009年8月至2014年8月在成都軍區(qū)總醫(yī)院神經(jīng)內(nèi)科住院的發(fā)病24 h內(nèi)首次臨床診斷為前循環(huán)TIA及認(rèn)知量表評(píng)定正常的50例患者,發(fā)病1周內(nèi)進(jìn)行全腦CTPI檢查,分別監(jiān)測(cè)感興趣區(qū)域腦血容量(cerebral blood volume,CBV)、腦血流量(cerebral blood flow,CBF)、平均通過(guò)時(shí)間(mean transit time,MTT)、達(dá)峰時(shí)間(time to peak,TTP);發(fā)病第4周進(jìn)行認(rèn)知量表評(píng)價(jià),根據(jù)認(rèn)知量表結(jié)果分為VCI組與對(duì)照組,比較2組患者早期CTPI灌注參數(shù)的差異,并將VCI組認(rèn)知量表評(píng)分與灌注參數(shù)進(jìn)行相關(guān)性分析。結(jié)果 VCI組與對(duì)照組在年齡、性別、血壓、血脂、血糖、同型半胱氨酸、前循環(huán)TIA發(fā)作至入院平均時(shí)間及前循環(huán)TIA發(fā)作至完成CTPI的平均時(shí)間等方面結(jié)果相仿,基線水平無(wú)統(tǒng)計(jì)學(xué)差異;VCI組與對(duì)照組相比,VCI組CBF降低,MTT、TTP明顯延長(zhǎng),差異有統(tǒng)計(jì)學(xué)意義(P0.05);2組患者CBV相仿,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);Spearman相關(guān)性分析顯示Mo CA與VCI組MTT值負(fù)相關(guān)(r=-0.51,P=0.009)。結(jié)論 TIA發(fā)生后腦血流灌注降低與認(rèn)知功能下降的發(fā)生有一定相關(guān)性,提示CTPI對(duì)前循環(huán)TIA后VCI早期預(yù)警有一定診斷價(jià)值。
[Abstract]:Objective to evaluate whether cognitive impairment is associated with cerebral blood flow (CBF) after first TIA using cerebral CT perfusion imaging. Methods from August 2009 to August 2014, 50 patients who were hospitalized in Department of Neurology, Chengdu military region General Hospital for the first time in 24 hours were assessed as normal by anterior circulation TIA and cognitive scale. The whole brain CTPI was performed within one week of onset. The cerebral blood volume (cerebral blood), cerebral blood flow (cerebral blood flow-CBF), mean (mean transit time (mean transit time), peak time (time to peak-tp) were monitored in the region of interest respectively, and the cognitive scales were evaluated at the 4th week of the disease, and were divided into VCI group and control group according to the results of the cognitive scale. The differences of early CTPI perfusion parameters between the two groups were compared, and the correlation between the cognitive scale scores and perfusion parameters in VCI group was analyzed. Results the results of age, sex, blood pressure, blood lipid, blood glucose, homocysteine, mean time from onset to admission of TIA in anterior circulation and average time from onset of TIA to completion of CTPI in VCI group were similar to those in control group. There was no statistical difference in baseline level. The CBF of VCI group was significantly longer than that of control group. The difference was statistically significant (P0.05). There was no significant difference in CBV between two groups (P0.05). The Spearman correlation analysis showed that the MTT value of VCI group was negatively correlated with that of Mo CA group (r-0.51g, P 0.009). Conclusion the decrease of cerebral blood flow perfusion after TIA is associated with cognitive impairment, which suggests that CTPI is valuable in early warning of VCI after anterior circulation TIA.
【作者單位】： 第三軍醫(yī)大學(xué)研究生管理大隊(duì);成都軍區(qū)總醫(yī)院神經(jīng)內(nèi)科;
【基金】：成都軍區(qū)醫(yī)學(xué)科學(xué)技術(shù)研究“十二五”計(jì)劃研究項(xiàng)目(C12045) 成都軍區(qū)總醫(yī)院重點(diǎn)研究項(xiàng)目(2013YG-A006)~~
【分類號(hào)】：R749.1

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