Introduction: The research focuses on the clinical study of cerebral angioarchitectonics and microcirculation disorders in the development of Alzheimer’s disease (AD) in comparison with other neurodegenerative and is...Introduction: The research focuses on the clinical study of cerebral angioarchitectonics and microcirculation disorders in the development of Alzheimer’s disease (AD) in comparison with other neurodegenerative and ischemic lesions. Materials and methods: 1117 patients with different types and stages of neurodegenerative and ischemic lesions were examined, 93 of whom (8.33%) had different stages of AD—Test Group;1024 (91.67%) had cerebral atherosclerosis, Binswanger disease (BD), vascular Parkinsonism (VP)—Control Group. The examination included definition of CDR, MMSE, cerebral CT, MRI, cerebral sciagraphy (SG), rheoencephalography (REG), morphometric detection of AD stages with TDR, and cerebral multi-gated angiography (MUGA). Results: In all patients with AD, regardless of the disease stage, specific сerebral small vessel disease (CSVD), manifested by dyscirculatory angiopathy of Alzheimer’s type (DAAT), was detected in the temporal and fronto-parietal areas. Conclusions: DAAT is an AD-specific lesion of cerebral microvessels that changes hemodynamics, causes cerebral hypoxia, and contributes to impaired amyloid beta metabolism. The combination of deposition of amyloid beta in the cerebral tissue and vascular wall, as well as specific disorders of microcirculation, cause neurodegeneration and AD development. Patients with other neurodegenerative and ischemic lesions had no DAAT manifestations.展开更多
目的分析影响老年脑小血管病(cerebral small vessel disease,CSVD)患者发生认知功能障碍(cognition impairment,CI)的危险因素。方法回顾性分析2016年8月到2019年9月我院收治102例老年CSVD患者资料,患者采用蒙特利尔认知评估(MoCA)量...目的分析影响老年脑小血管病(cerebral small vessel disease,CSVD)患者发生认知功能障碍(cognition impairment,CI)的危险因素。方法回顾性分析2016年8月到2019年9月我院收治102例老年CSVD患者资料,患者采用蒙特利尔认知评估(MoCA)量表进行评分,以26分为界线评价患者有无认知功能障碍,53例患者(<26分)纳入CI组(存在认知功能障碍),49例(≥26分)患者纳入对照组(不存在认知功能障碍)。比较两组患者认知功能评分,痴呆症发生情况,影响CSVD患者发生CI单因素和多因素分析。结果CI组患者注意、记忆、空间及执行功能、抽象思维、语言、定向、命名、计算等各项认知功能评分显著低于对照组(P<0.05);CI组患者痴呆症发生率(39.62%)高于对照组(6.12%),差异有统计学意义(P<0.05);单因素分析显示CI组患者年龄(>65岁)、学历、既往脑梗死人数、高血压人数、高血脂、吸烟史(超过5年)人数、总胆固醇和尿酸水平显著高于对照组患者(P<0.05),多因素分析结果显示脑梗死、高血压、高血脂和吸烟史为影响CSVD患者发生CI危险因素。结论CSVD患者发生CI后容易出现痴呆,脑梗死、高血压、高血脂和吸烟史为CSVD患者发生CI危险因素。展开更多
脑小血管病(cerebral small vessel disease,CSVD)是由于颅内微小血管的动态弥漫性病变所致的脑微血管疾病,是脑卒中和血管性痴呆的主要病因,具有高隐匿性、高发病率、高致残率等特点,发病机制可能与脑血流量减少或慢性大脑低灌注、内...脑小血管病(cerebral small vessel disease,CSVD)是由于颅内微小血管的动态弥漫性病变所致的脑微血管疾病,是脑卒中和血管性痴呆的主要病因,具有高隐匿性、高发病率、高致残率等特点,发病机制可能与脑血流量减少或慢性大脑低灌注、内皮功能障碍、血-脑脊液屏障功能受损、炎症反应和遗传等因素有关。为有效探寻CSVD的中西医病理机制及防治方法,制备合适的且能展示中医药特色优势的动物模型尤为重要。当前构建的CSVD动物模型有低灌注损伤CSVD模型、高血压靶器官损伤CSVD模型、基因修饰CSVD模型、微小栓子栓塞CSVD模型等。从CSVD模型的建立、行为学与病理改变、模型的优缺点等角度综述了近年来国内外有关CSVD动物模型的研究进展,旨在为深入探索CSVD的发病机制和靶向防治脑小血管病的创新药物研发提供模式动物参考。展开更多
文摘Introduction: The research focuses on the clinical study of cerebral angioarchitectonics and microcirculation disorders in the development of Alzheimer’s disease (AD) in comparison with other neurodegenerative and ischemic lesions. Materials and methods: 1117 patients with different types and stages of neurodegenerative and ischemic lesions were examined, 93 of whom (8.33%) had different stages of AD—Test Group;1024 (91.67%) had cerebral atherosclerosis, Binswanger disease (BD), vascular Parkinsonism (VP)—Control Group. The examination included definition of CDR, MMSE, cerebral CT, MRI, cerebral sciagraphy (SG), rheoencephalography (REG), morphometric detection of AD stages with TDR, and cerebral multi-gated angiography (MUGA). Results: In all patients with AD, regardless of the disease stage, specific сerebral small vessel disease (CSVD), manifested by dyscirculatory angiopathy of Alzheimer’s type (DAAT), was detected in the temporal and fronto-parietal areas. Conclusions: DAAT is an AD-specific lesion of cerebral microvessels that changes hemodynamics, causes cerebral hypoxia, and contributes to impaired amyloid beta metabolism. The combination of deposition of amyloid beta in the cerebral tissue and vascular wall, as well as specific disorders of microcirculation, cause neurodegeneration and AD development. Patients with other neurodegenerative and ischemic lesions had no DAAT manifestations.
文摘目的分析影响老年脑小血管病(cerebral small vessel disease,CSVD)患者发生认知功能障碍(cognition impairment,CI)的危险因素。方法回顾性分析2016年8月到2019年9月我院收治102例老年CSVD患者资料,患者采用蒙特利尔认知评估(MoCA)量表进行评分,以26分为界线评价患者有无认知功能障碍,53例患者(<26分)纳入CI组(存在认知功能障碍),49例(≥26分)患者纳入对照组(不存在认知功能障碍)。比较两组患者认知功能评分,痴呆症发生情况,影响CSVD患者发生CI单因素和多因素分析。结果CI组患者注意、记忆、空间及执行功能、抽象思维、语言、定向、命名、计算等各项认知功能评分显著低于对照组(P<0.05);CI组患者痴呆症发生率(39.62%)高于对照组(6.12%),差异有统计学意义(P<0.05);单因素分析显示CI组患者年龄(>65岁)、学历、既往脑梗死人数、高血压人数、高血脂、吸烟史(超过5年)人数、总胆固醇和尿酸水平显著高于对照组患者(P<0.05),多因素分析结果显示脑梗死、高血压、高血脂和吸烟史为影响CSVD患者发生CI危险因素。结论CSVD患者发生CI后容易出现痴呆,脑梗死、高血压、高血脂和吸烟史为CSVD患者发生CI危险因素。
文摘脑小血管病(cerebral small vessel disease,CSVD)是由于颅内微小血管的动态弥漫性病变所致的脑微血管疾病,是脑卒中和血管性痴呆的主要病因,具有高隐匿性、高发病率、高致残率等特点,发病机制可能与脑血流量减少或慢性大脑低灌注、内皮功能障碍、血-脑脊液屏障功能受损、炎症反应和遗传等因素有关。为有效探寻CSVD的中西医病理机制及防治方法,制备合适的且能展示中医药特色优势的动物模型尤为重要。当前构建的CSVD动物模型有低灌注损伤CSVD模型、高血压靶器官损伤CSVD模型、基因修饰CSVD模型、微小栓子栓塞CSVD模型等。从CSVD模型的建立、行为学与病理改变、模型的优缺点等角度综述了近年来国内外有关CSVD动物模型的研究进展,旨在为深入探索CSVD的发病机制和靶向防治脑小血管病的创新药物研发提供模式动物参考。
