Brain perfusion and cognitive function changes in hypertensive patients
Brain perfusion and cognitive function changes in hypertensive patients
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DOI：
10.1291/hypres.31.673
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发表时间：
2008-04-01
影响因子：
5.4
通讯作者：
Lishmanov, Yuri B.
中科院分区：
文献类型：
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作者：
Efimova, Irina Yu.;Efimova, Nataliya Yu.;Lishmanov, Yuri B.
本研究的目的是评估动脉性高血压（AH）患者在药物治疗前后的脑灌注和认知功能（CF）。该研究纳入了15例既往未经治疗或治疗无效的原发性二度高血压患者（平均年龄53.0 ± 5.7岁）。所有患者均在治疗前和治疗后24周（血管紧张素转换酶[ACE]抑制剂或利尿剂）进行脑单光子发射计算机断层扫描（SPECT）和综合神经心理学测试。AH患者所有区域的脑灌注均显著降低（15-22%）。这些患者的注意力和精神速度下降了25%，精神状态下降了14%。六个月的冲击治疗导致所有脑区的脑灌注平均增加7-11%。治疗后，这些患者表现出平均11-18%的注意力和精神速度的改善，以及平均10%的抽象精神状态的改善。脑灌注不足和CF受损的显著体征：即使没有局灶性神经系统疾病的高血压患者也发现注意力下降，精神速度减慢和精神状态。用ACE抑制剂或利尿剂进行24周的强化治疗对脑灌注有积极影响，并导致CF改善。
The aim of our study was to estimate brain perfusion and cognitive function (CF) in patients with arterial hypertension (AH) before and after hypotensive therapy. The study included 15 patients (mean age, 53.0 +/- 5.7 years) with previously untreated or ineffectively treated essential hypertension of the second degree. All patients underwent brain single photon emission computed tomography (SPECT) scanning with Tc-99m-hexamethylpropylene amine oxime (Tc-99m-HMPAO) and comprehensive neuropsychological testing before and after 24 weeks of hypotensive therapy (angiotensin-converting enzyme [ACE] inhibitor or diuretics). The brain perfusion was significantly lower (15-22%) in all regions of AH patients. These patients showed a 25% decrease in attention and psychomotor speed as well as a 14% decrease in mentation. Six months of hypotensive therapy led to an increase in brain perfusion by an average of 7-11% in all brain regions. After treatment these patients demonstrated an average 11-18% improvements in attention and psychomotor speed, as well as an average 10% improvement in abstract mentation. Marked signs of brain hypoperfusion and impaired CF: decrease in attention, slowing psychomotor speed and mentation was found in hypertensive patients even without focal neurological symptomatology. Twenty-four weeks of hypotensive treatment with ACE inhibitors or diuretics had a positive effect on cerebral perfusion and led to CF improvement.