The Correlation Study Of Brachial-ankle Pulse Wave Velocity And White Matter Lesions With Cognitive Impairment In Middle-aged And Elderly Patients

Objective:To explore the relationship between brachial-ankle pulse wave velocity and white matter lesions with cognitive dysfunction,and to analyze its clinical significance.Methods:1.141 patients who met the criteria of inclusion and exclusion criteria were collected,and all patients have completed the following examinations or test,including head magnetic resonance scan,brachial-ankle pulse wave velocity(baPWV),Montreal Cognitive Assessment(MoCA),and related biochemical indexes assay;2.The qualitative analysis: Patients with white matter lesion were groped by Fazekas,and were divided into 0 to 3 level,and 0 level was used as the control group.To analyze the correlation of general clinical data and baPWV;To analyze the differences of cognitive scores between in four groups and the correlation of cognitive impairment and baPWV;3.The quantitative analysis: To use Image pro plus 6.0 to measure the volume of white matter lesions,and to compare the volume of white matter of patients in various levels;to analyze the correlation of cognitive impairment and the volume of white matter lesions;4.To use multivariate linear regression analysis to conduct multivariate analysis of white matter lesions and screen its risk factors.Results:1.General baseline data,including age,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,,hypersensitive c-reactive protein,hypertension,diabetes,smoking,and drinking were significantly different in different levels’ white matter lesions(P<0.05),baPWV was also significantly different in different levels’ white matter lesions(P<0.05).2.The degree of white matter lesion was compared with MoCA scores and its sub-items,and it was found that abstract thinking,visual space,executive ability and delayed memory were different in each group(P<0.05),and baPWV and MoCA scores were significantly correlated(r=-0.794,P<0.01).3.There were differences in various levels of white matter lesions with the volume of white matter in patients(P<0.05);The volume of white matter lesions was negatively correlated with naming,language,abstract thinking,orientation,visual space and executive ability,attention and computational power,delayed memory and total score of MoCA,and the correlation coefficient was between 0.171-0.683,P<0.05.and baPWV was positively correlated with the volume of white matter lesions(r=0.780,P<0.01).4.Multiple linear regression analysis showed that the risk factors of white matter lesions were age,total cholesterol,high-density lipoprotein cholesterol,,hypersensitive c-reactive protein,and baPWV,among which baPWV is one of the primary risk factors.Conclusion:1.Visual space and executive function,and delayed recall are severely impaired in middle-aged and elderly patients with white matter injury,Brachial-ankle pulse wave velocity is correlated with cognitive function,and cognitive functions such as abstract thinking;2.The more severe the degree of brachial-ankle pulse wave velocity is,the greater the volume of white matter damage will be,and the more severe the cognitive impairment will be;3.Brachial-ankle pulse wave velocity may be one of the key risk factors for white matter damage in middle-aged and elderly patients,so early monitoring of arteriosclerosis in middle-aged and elderly patients is necessary.