摘要
目的探讨老年类风湿关节炎(RA)患者脑白质疏松(LA)与脑血管反应性(CVR)的关系。方法选取2020年10月-2021年10月西安市第五医院确诊的老年RA患者210例作为观察组,年龄60~77岁,平均年龄(65.03±3.25)岁;同时选取120例老年人作为年龄-疾病对照组,年龄60~79岁,平均年龄(65.59±3.22)岁。所有患者均完善头颅磁共振(MRI)评估脑白质疏松(LA)情况,同时应用经颅多普勒超声(TCD)通过屏气指数(BHI)评估脑血管反应性(CVR),分析两组患者LA及BHI变化情况,同时分析两组患者不同部位的LA与BHI关系。结果观察组LA比例(71.0%)明显高于对照组(60.0%),有统计学差异(P=0.042),BHI明显低于对照组(P=0.008);观察组脑深部白质损害比例(24.8%)高于对照组(15.0%),两组差异有统计学意义(P=0.037),而侧脑室周围白质损害比例(58.1%)虽高于对照组(48.3%),但两组差异无统计学意义(P=0.087);观察组脑深部白质损伤患者BHI与对照组差异不大(t=1.286,P=0.203),其侧脑室周围LA患者的BHI与对照组相比差异有统计学意义(t=2.185,P=0.030)。结论老年RA患者LA比例明显升高而CVR性明显下降,其脑深部白质疏松比例明显升高,侧脑室周围白质疏松患者脑功能储备能力较对照组明显下降。
Objective To observe the relationship between leukoaraiosis(LA)and cerebrovascular reactivity(CVR)in elderly patients with rheumatoid arthritis(RA);Methods There were 210 elderly patients with RA diagnosed in our hospital selected as the observation group.120 elderly people were selected as the age disease control group.All patients improved cranial magnetic resonance(MRI)to evaluate LA.At the same time,transcranial Doppler(TCD)was used to evaluate CVR through breath holding index(BHI).The changes of LA and BHI in the two groups were analyzed,and the relationship between LA and BHI in different parts of the two groups was analyzed.Results The proportion of LA in the observation group(71.0%)was significantly higher than that in the control group(60.0%)(P=0.042),and BHI was significantly lower than that in the control group(P=0.008).The proportion of deep white matter damage in the observation group(24.8%)was higher than that in the control group(15.0%)(P=0.037),while the proportion of white matter damage around the lateral ventricle(58.1%)was higher than that in the control group(48.3%),but there was no significant difference between the two groups(P=0.087).There was no significant difference in BHI between the observation group and the control group(t=1.286,P=0.203),but there was significant difference in BHI between the patients with LA around the lateral ventricle and the control group(t=2.185,P=0.030).Conclusions The proportion of LA in elderly RA patients increased significantly,while the CVR decreased significantly.The proportion of LA in deep brain increased significantly,and the brain function reserve ability of patients with periventricular LA decreased significantly compared with the control group.
作者
闫俊
李娟
叶楠
高亚亚
陈沛
刘丹
Yan Jun;Li Juan;Ye Nan;Gao Yaya;Chen Pei;Liu Dan(Department of Neurology,the Fifth Hospital of Xi'an,Shaanxi 710082,China)
出处
《脑与神经疾病杂志》
CAS
2023年第6期367-371,共5页
Journal of Brain and Nervous Diseases
基金
陕西省自然科学基础研究计划重点项目(2021JZ-59)
陕西省重点研发计划项目(2021SF-259)
西安市科技局社会发展引导计划[2017118SF/YX012(7)]
西安市第五医院院内课题(2021lc03)。
关键词
类风湿关节炎
老年
脑白质疏松
脑血管反应性
R]heumatoid arthritis
Elderly
Leukoaraiosis
Cerebrovascular reactivity
