| 12 | 0 | 35 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 旨在评估脑小血管病(CSVD)患者步态障碍与CSVD总负荷及影像学标志物的相关性。方法 回顾性纳入2023年1～12月于河北医科大学第三医院神经内科住院的CSVD患者140例，分为轻度组61例和重度组79例。利用磁共振成像(MRI)记录所有CSVD患者影像学标志物，包括脑白质高信号、腔隙性脑梗死、脑微出血和扩大的血管周围间隙，并计算CSVD总负荷(范围0～4分)。通过步态分析定量评估、Tinetti测试、起立行走计时测试(TUG)评估步态障碍。采用多因素Logistic回归分析步态障碍与CSVD总负荷及单一影像学标志物的相关性。结果 在调整年龄、性别、身高和脑血管病危险因素后，多变量线性回归分析显示，较高的CSVD总负荷与步速、步长、TUG及Tinetti评分显著有关；中重度脑白质高信号与步速、Tinetti评分显著有关；腔隙性脑梗死与步速、步宽、TUG评分显著有关；脑微出血与步速、步长显著有关；中重度血管周围间隙扩大与TUG及Tinetti评分显著有关(均P<0.05)。结论 CSVD患者步态障碍与CSVD总负荷及独立CSVD影像学标志物相关，表明CSVD总负荷能更全面评估CSVD患者步态障碍。
Abstract：1 Wardlaw JM,Smith EE,Biessels GJ,et al.Neuroimaging standards for research into small vessel disease and its contributionto ageing and neurodegeneration[J].Lancet Neurol,2013;12:822-38.
2 van der Holst HM,van Uden IW,Tuladhar AM,et al.Factors associated with 8-year mortality in older patients with cerebral small vessel disease:the radboud university nijmegen diffusion tensor and magnetic resonance cohort(RUN DMC) study[J].JAMA Neurol,2016;73(4):402-9.
3 孙彦，李春玲，李萍.运动干预对老年步态障碍患者功能康复影响的研究进展[J].中国老年学杂志，2013;33(16):4079-81.
4 de Laat KF,van Norden AG,Gons RA,et al.Gait in elderly with cerebral small vessel disease[J].Stroke,2010;41(8):1652-8.
5 Blumen HM,Jayakody O,Verghese J.Gait in cerebral small vessel disease,pre-dementia,and dementia:a systematic review[J].Int J Stroke,2023;18(1):53-61.
6 Su C,Yang X,Wei S,et al.Association of cerebral small vessel disease with gait and balance disorders[J].Front Aging Neurosci,2022;14:834496.
7 Su N,Zhai FF,Zhou LX,et al.Cerebral small vessel disease burden is associated with motor performance of lower and upper extremities in community-dwelling populations[J].Front Aging Neurosci,2017;9:313.
8 Smith EE,O′Donnell M,Dagenais G,et al.Early cerebral small vessel disease and brain volume,cognition,and gait[J].Ann Neurol,2015;77(2):251-61.
9 de Laat KF,van den Berg HA,van Norden AG,et al.Microbleeds are independently related to gait disturbances in elderly individuals with cerebral small vessel disease[J].Stroke,2011;42(2):494-7.
10 Sharma B,Wang M,McCreary CR,et al.Gait and falls in cerebral small vessel disease:a systematic review and meta-analysis[J].Age Ageing,2023;52:1-15.
11 彭丹涛，邵文.脑小血管病相关认知功能障碍中国诊疗指南(2019)[J].阿尔茨海默病及相关病，2019;2(3):405-7,403.
12 龚晓芹，钟平，曹立.神经科疾病常用的步态评估方法[J].中华神经科杂志，2022;55(2):174-80.
13 Zhao P,Gu Y,Feng W,et al.Gait disorders and magnetic resonance imaging characteristics in older adults with cerebral small vessel disease[J].J Integr Neurosci,2022;21(5):129.
14 Li P,Wang Y,Jiang Y,et al.Cerebral small vessel disease is associated with gait disturbance among community-dwelling elderly individuals:the Taizhou imaging study[J].Aging(Albany NY),2020;12(3):2814-24.
15 Iseki K,Hanakawa T,Hashikawa K,et al.Gait disturbance associated with white matter changes:a gait analysis and blood flow study[J].Neuroimage,2010;49(2):1659-66.
16 Jiang MZ,Wu S,Zhang YY,et al.Impact of white matter hyperintensity and age on gait parameters in patients with cerebral small vessel disease[J].J Am Med Dir Assoc,2023;24(5):672-8.
17 de Laat KF,van Norden AG,Gons RA,et al.Gait in elderly with cerebral small vessel disease[J].Stroke,2010;41(8):1652-8.
18 Su C,Yang X,Wei S,et al.Periventricular white matter hyperintensities are associated with gait and balance in patients with minor stroke[J].Front Neurol,2022;13:941668.
19 Mao HJ,Zhang JX,Zhu WC,et al.Basal ganglia and brainstem located cerebral microbleeds contributed to gait impairment in patients with cerebral small vessel disease[J].J Alzheimers Dis,2023;94(3):1005-12.
20 Hou Y,Yang S,Li Y,et al.Impact of cerebral microbleeds on gait,balance,and upper extremities function in cerebral small vessel disease[J].J Integr Neurosci,2023;22(4):82.
21 Pinter D,Ritchie SJ,Doubal F,et al.Impact of small vessel disease in the brain on gait and balance[J].Sci Rep,2017;7:41637.
22 Mukli P,Detwiler S,Owens CD,et al.Gait variability predicts cognitive impairment in older adults with subclinical cerebral small vessel disease[J].Front Aging Neurosci,2022;14:1052451.
23 Hou Y,Yang S,Li Y,et al.Association of enlarged perivascular spaces with upper extremities and gait impairment:an observational,prospective cohort study[J].Front Neurol,2022;13:993979.
24 Su N,Zhai FF,Zhou LX,et al.Cerebral small vessel disease burden is associated with motor performance of lower and upper extremities in community-dwelling populations[J].Front Aging Neurosci,2017;9:313.
基本信息:
中图分类号:R743
引用信息:
[1]刘翠翠,任慧玲,徐玉珠,等.脑小血管病患者步态障碍与其神经影像学标志物的相关性[J].中国老年学杂志,2026,46(15):2694-2699.
基金信息:
河北省卫生健康委医学科研课题(20242292,20240198)
2026-08-10
2026-08-10