Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns...Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease(age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease(age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls(age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitiv展开更多
文摘目的 观察潜阳育阴颗粒对阴虚阳亢型高血压早期肾损害患者的临床疗效。方法 将60例阴虚阳亢型老年高血压早期肾损害病例,随机分为对照组(30例)和观察组(30例),对照组常规使用西药氨氯地平(或者联合缬沙坦)降压,观察组在对照组降压治疗维持达标的基础上服用中药潜阳育阴颗粒。24周后比较2组患者治疗前后的临床疗效、单光子发射计算机化体层显像术(SPECT)检测肾小球滤过率(GFR)和胱抑素C(Cyst-C)、尿β2微球蛋白(β2-MG)以及尿N 乙酰β-D葡萄糖苷酶(NAG)等早期肾损害指标的变化情况。结果 治疗后观察组和对照组的有效率分别为96%和50%,2组比较有显著性差异, P < 0.01;2组肾损害指标Cyst-C、β2-MG水平均有显著改善( P < 0.05 ),观察组较对照组改善效果更为显著( P < 0.05 );观察组肾损害指标(GFR、NAG)有显著改善( P < 0.05 );观察组优于对照组( P < 0.05 )。结论 潜阳育阴颗粒在降压达标基础上能够有效减少高血压患者的早期肾脏损害,改善临床症状。
基金supported by the National Natural Science Foundation of China,No.81771237(to YXG)the National Key Basic Research Program of China(973 Program),No.2014CB541604(to YXG)+1 种基金the "Shu Guang" Project of Shanghai Municipal Education Commission and Shanghai Education Development Foundation,China,No.16SG02(to LC)the Scientific Research Project of Huashan Hospital of Fudan University of China,No.2016QD082(to YL)
文摘Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease(age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease(age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls(age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitiv
