Efimova Nataliya Y, Chernov Vladimir I, Efimova Irina Y, Lishmanov Yuri B
Federal State Budgetary Scientific Institution, Research Institute for Cardiology, Tomsk, Russia.
National Research Tomsk Polytechnic University, Tomsk, Russia.
Cardiovasc Ther. 2015 Aug;33(4):209-15. doi: 10.1111/1755-5922.12136.
To investigate the regional cerebral blood flow, cognitive function, and parameters of 24-h arterial blood pressure monitoring in patients with metabolic syndrome before and after combination antihypertensive therapy.
The study involved 54 patients with metabolic syndrome (MetS) investigated by brain single-photon emission computed tomography, 24-h blood pressure monitoring (ABPM), and comprehensive neuropsychological testing before and after 24 weeks of combination antihypertensive therapy.
Patients with metabolic syndrome had significantly poorer regional cerebral blood flow compared with control group: by 7% (P = 0.003) in right anterior parietal cortex, by 6% (P = 0.028) in left anterior parietal cortex, by 8% (P = 0.007) in right superior frontal lobe, and by 10% (P = 0.00002) and 7% (P = 0.006) in right and left temporal brain regions, correspondingly. The results of neuropsychological testing showed 11% decrease in mentation (P = 0.002), and 19% (P = 0.011) and 20% (P = 0.009) decrease in immediate verbal and visual memory in patients with MetS as compared with control group. Relationships between the indices of ABPM, cerebral perfusion, and cognitive function were found. Data showed an improvement of regional cerebral blood flow, ABPM parameters, and indicators of cognitive functions after 6 months of antihypertensive therapy in patients with MetS.
The study showed the presence of diffuse disturbances in cerebral perfusion is associated with cognitive disorders in patients with metabolic syndrome. Combination antihypertensive treatment exerts beneficial effects on the 24-h blood pressure profile, increases cerebral blood flow, and improves cognitive function in patients with MetS.
研究代谢综合征患者联合降压治疗前后的局部脑血流量、认知功能及24小时动脉血压监测参数。
本研究纳入54例代谢综合征（MetS）患者，在联合降压治疗24周前后，通过脑单光子发射计算机断层扫描、24小时血压监测（ABPM）及综合神经心理学测试进行调查。
与对照组相比，代谢综合征患者的局部脑血流量明显较差：右侧顶叶前部皮质降低7%（P = 0.003），左侧顶叶前部皮质降低6%（P = 0.028），右侧额上叶降低8%（P = 0.007），右侧和左侧颞叶脑区分别降低10%（P = 0.00002）和7%（P = 0.006）。神经心理学测试结果显示，与对照组相比，MetS患者的智力下降11%（P = 0.002），即时言语和视觉记忆分别下降19%（P = 0.011）和20%（P = 0.009）。发现了ABPM指标、脑灌注和认知功能之间的关系。数据显示，MetS患者在接受6个月的降压治疗后，局部脑血流量、ABPM参数和认知功能指标有所改善。
该研究表明，代谢综合征患者存在弥漫性脑灌注障碍与认知障碍有关。联合降压治疗对24小时血压状况产生有益影响，增加脑血流量，并改善MetS患者的认知功能。
