Intracranial artery stenosis and progression from mild cognitive impairment to Alzheimer disease
Intracranial artery stenosis and progression from mild cognitive impairment to Alzheimer disease
复制标题
颅内动脉狭窄和从轻度认知障碍到阿尔茨海默病的进展
DOI：
10.1212/wnl.0000000000000185
复制
发表时间：
2014-03-11
期刊：
影响因子：
9.9
通讯作者：
Zhou, Huadong
中科院分区：
文献类型：
--
作者：
Zhu, Jie;Wang, Yanjiang;Zhou, Huadong
目的：探讨颅内动脉狭窄对轻度认知功能障碍（MCI）向阿尔茨海默病（AD）发展的影响。方法：对423例MCI患者进行为期4年的临床和神经心理学检查。研究AD所致痴呆的发病率。CT血管造影用于测量研究人群中颅内主要动脉的狭窄程度。采用混合效应回归模型分析颅内动脉狭窄与MCI进展之间的关系，并采用简易精神状态检查和日常生活活动量表进行评估。考克斯比例风险模型用于确定颅内动脉狭窄和痴呆进展之间的关联。结果：在随访结束时，116名参与者因AD进展为痴呆，而223名仍处于MCI阶段。中度或重度颅内动脉狭窄的受试者相对于无此类狭窄的受试者，认知和功能下降更快。中度或重度颅内动脉狭窄的存在显著增加痴呆进展的风险，即使在控制了年龄、性别、教育、血管危险因素和无症状MRI病变后。结论：颅内动脉狭窄增加MCI后发生AD痴呆的风险。
Objective: To assess the impact of intracranial arterial stenosis on the progression from mild cognitive impairment (MCI) to Alzheimer disease (AD). Methods: A total of 423 participants with MCI were included and evaluated with clinical and neuropsychological examinations annually for 4 years. The incidence of dementia due to AD was investigated. CT angiography was used to measure the stenosis of major intracranial arteries in the studied population. A mixed-effects regression model was used to analyze the association between intracranial arterial stenosis and the progression of MCI, which was assessed with the Mini-Mental State Examination and the Activities of Daily Living scale. Cox proportional hazards models were used to identify the association between intracranial arterial stenosis and dementia progression. Results: At the end of the follow-up, 116 participants had progressed to dementia due to AD, while 223 remained in the MCI stage. Participants with moderate or severe intracranial arterial stenosis had a faster decline in cognition and function relative to participants without such stenosis. The presence of moderate or severe intracranial arterial stenosis significantly increased the risk of dementia progression, even after controlling for age, sex, education, vascular risk factors, and silent MRI lesions. Conclusions: Intracranial arterial stenosis increased the risk of developing AD dementia after MCI.