严重脑白质高信号可预测有脑血管疾病史患者的严重认知功能衰退。
Severe cerebral white matter hyperintensities predict severe cognitive decline in patients with cerebrovascular disease history.
作者信息
Dufouil Carole, Godin Ophélia, Chalmers John, Coskun Oghuzan, MacMahon Stephen, Tzourio-Mazoyer Nathalie, Bousser Marie-Germaine, Anderson Craig, Mazoyer Bernard, Tzourio Christophe
出版信息
Stroke. 2009 Jun;40(6):2219-21. doi: 10.1161/STROKEAHA.108.540633. Epub 2009 Apr 23.
BACKGROUND AND PURPOSE
Cerebral white matter hyperintensities (WMHs) are believed to be the consequence of small vessel disease, and it is uncertain whether their extent predicts the risk of dementia in patients with vascular disease history. Method- Brain MRI was performed in 226 participants of the PROGRESS study. WMH severity was assessed using a visual rating scale. During follow-up, patients were classified for incident severe cognitive deterioration (including dementia) using standard criteria.
RESULTS
Over 4-year follow-up, the incidence of severe cognitive deterioration ranged from 1.1 to 9.1 per 100 person-years in patients with respectively no or severe WMHs at baseline. In multivariable analysis, incident severe cognitive deterioration was associated with baseline severe WMHs (odds ratio=7.7, P<0.005).
CONCLUSIONS
Higher WMH load is a strong predictor of dementia and cognitive decline in patients with cerebrovascular disease history.
背景与目的
脑白质高信号（WMHs）被认为是小血管疾病的结果，其范围是否能预测有血管疾病史患者的痴呆风险尚不确定。方法：对226名PROGRESS研究参与者进行脑部MRI检查。使用视觉评分量表评估WMH严重程度。在随访期间，根据标准标准将患者分类为发生严重认知功能恶化（包括痴呆）。
结果
在4年的随访中，基线时无或有严重WMHs的患者中，严重认知功能恶化的发生率分别为每100人年1.1至9.1例。在多变量分析中，发生严重认知功能恶化与基线严重WMHs相关（优势比=7.7，P<0.005）。
结论
较高的WMH负荷是有脑血管疾病史患者痴呆和认知衰退的有力预测指标。
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