[原发性高血压中年患者的脑灌注、认知功能和血管年龄]
[Brain Perfusion, Cognitive Functions, and Vascular Age in Middle Aged Patients With Essential Arterial Hypertension].
作者信息
Parfenov V A, Ostroumova T M, Pеrepelova E M, Perepelov V A, Kochetkov A I, Ostroumova O D
机构信息
Federal State Budgetary Educational Institution of Higher Education "I. M. Sechenov First Moscow State Medical University" of the Ministry of Health of the Russian Federation.
Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation.
出版信息
Kardiologiia. 2018 May(5):23-31.
OBJECTIVE
This study aimed to assess the cognitive functions and cerebral blood flow measured with arterial spin labeling (ASL) and their possible correlations with vascular age in untreated middle-aged patients with grade 1-2 essential arterial hypertension (EAH).
METHODS
We examined 73 subjects aged 40-59 years (33 with EAH and 40 healthy volunteers [controls]). Neuropsychological assessment included Montreal Cognitive Assessment (MoCA), Trail Making test (part A and part B), Stroop Color and Word Test, verbal fluency test (phonemic verbal fluency and semantic verbal fluency), 10‑item word list learning task. All subjects underwent brain MRI. MRI protocol included ASL. Vascular age was calculated by two techniques - using Framingham Heart Study risk tables and SCORE project scales.
RESULTS
Patients with EAH had lower performance on phonemic verbal fluency test and lower mean MoCA score (29.2±1.4 vs. 28.1±1.7 points) compared to controls (13.4±3.2, р=0.002; 29.2±1.4, p=0.001, respectively). White matter hyperintensities (WMH) were present in 7.5 % controls and in 51.5 % EAH patients (р=0.0002). Cerebral blood flow (CBF) in EAH patients was lower in both right (39.1±5.6 vs. 45.8±3.2 ml / 100 g / min) and left frontal lobes of the brain (39.2±6.2 и 45.2±3.6 ml / 100 g / min, respectively) compared to controls (р.
目的
本研究旨在评估未经治疗的1-2级原发性高血压（EAH）中年患者的认知功能和通过动脉自旋标记（ASL）测量的脑血流量，以及它们与血管年龄的可能相关性。
方法
我们检查了73名年龄在40-59岁之间的受试者（33名患有EAH，40名健康志愿者[对照组]）。神经心理学评估包括蒙特利尔认知评估（MoCA）、连线测验（A部分和B部分）、斯特鲁普颜色和文字测验、语言流畅性测验（音素语言流畅性和语义语言流畅性）、10项单词列表学习任务。所有受试者均接受脑部MRI检查。MRI协议包括ASL。血管年龄通过两种技术计算——使用弗雷明汉心脏研究风险表和SCORE项目量表。
结果
与对照组相比，EAH患者在音素语言流畅性测试中的表现较低，平均MoCA评分也较低（分别为29.2±1.4分与28.1±1.7分）（分别为13.4±3.2，р=0.002；29.2±1.4，p=0.001）。7.5%的对照组和51.5%的EAH患者存在白质高信号（WMH）（р=0.0002）。与对照组相比，EAH患者右侧（39.1±5.6 vs. 45.8±3.2 ml / 100 g / min）和左侧额叶的脑血流量（CBF）均较低（分别为39.2±6.2和45.2±3.6 ml / 100 g / min）（р.
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