【摘要】 目的探讨老年高血压患者脑白质微结构变化情况及与认知功能的相关性。方法选择2016年1月至2019年6月河北医科大学第二医院收治的老年高血压患者86例作为对象,所有患者均完成CT检查,根据脑白质微结构情况分为异常组(43例)与正常组(43例)。比较两组临床资料及动态血压参数情况,进行多因素logistic回归模型分析,并研究脑白质对认知功能的相关性。结果单因素分析:患者的年龄、24h血压、昼间血压变异系数、夜间血压变异系数等与脑白质微结构变化有影响关系,差异有统计学意义(P<0.05);多因素logistic回归模型结果表明:高血压患者的年龄、24h收缩压、昼间收缩压变异系数、夜间收缩压变异系数是脑白质微结构变化的显著影响因素(P<0.05);SPSS Pearson相关性分析表明:老年高血压患者脑白质左侧扣带束扣带回FA值与蒙特利尔认知评估量表分值呈正相关,脑白质右侧下纵束MD值与记忆力和执行功能呈负相关(P<0.05)。结论年龄、24h收缩压、昼间收缩压变异系数、夜间收缩压变异系数能够引起脑白质微结构变化,且与认知障碍有一定的相关性。更多还原

【Abstract】 Objective To investigate the changes of white matter microstructure and its correlation with cognitive function in elderly patients with hypertension.Methods 86 elderly patients with hypertension admitted to the Second Hospital of Hebei Medical University from January 2016 to June 2019 were selected as the objects.All patients completed CT examination and were divided into abnormal group and normal group according to the microstructure of white matter.The clinical data and ambulatory blood pressure parameters were compared between the two groups.Multivariate logistic regression model was used to analyze the correlation between white matter and cognitive function.Results Univariate analysis: Patients’ age,24 h systolic blood pressure,daytime systolic blood pressure variation coefficient,night systolic blood pressure variation coefficient and brain white matter microstructure change,the difference was statistically significant(P<0.05);the results of multivariate logistic regression model showed that the factors with statistical significance obtained from the above univariate analysis were included in the multivariate logistic regression analysis,and the results were significant.There were statistically significant factors with age,24-hour systolic blood pressure,daytime systolic blood pressure variation coefficient and night systolic blood pressure variation coefficient(P<0.05).Pearson correlation analysis showed that FA value of left cingulate gyrus of white matter was positively correlated with Montreal Cognitive Assessment Scale score,while MD value of right lower longitudinal tract of white matter was negatively correlated with memory and executive function(P<0.05).Conclusion Age,24-hour systolic blood pressure,daytime systolic blood pressure variation coefficient,night systolic blood pressure variation coefficient can cause brain white matter microstructure changes,and have certain correlation with cognitive impairment.更多还原