Changes In Cognitive Function In Patients With Vascular Factors Of Ischemic Cerebrovascular Disease Research

Background and objectiveIn this study,to evaluate cognitive function as well as hemodynamic monitoring of the ischemic cerebrovascular disease, and to observe cerebral vascular reserve in patient with ischemic vascular cognitive impairment.Objective:①to investigate the cognitive function and hemodymanic change in patient with ischemic vascular cognitive impairment,which in relation to the vascular factors.②to investigate cerebral vascular reserve in patient with ischemic vascular cognitive impairment.Methods:This research is divided into two parts:Chapter One:According to Stroke Risk Scale (ESRS),60 patients with ischemic cerebrovascular disease risk were divided into light, medium risk group, and high risk group,. Using the Montreal Cognitive Assessment (MoCA) on ischemic cerebrovascular disease in order to assess the cognitive function of patients, including visual space and executive function, attention and calculation, ability of abstract, naming, memory, time orientation, digital shun back, digital fall back, alertness, language repetition, verbal fluency, is the orientati on time and location, a total of 14. By the use of transcranial Doppler cerebral blood flow in patients with mechanical testing, and to analyze the vascular factors on cognitive function.Chapter two:Transcranial Doppler and breathing-holding test is used to evaluate cerebral vascular reserve of patients with vascular cognitive impairment. The patients are divided into the VCI group and the normal group. Using the determination of the breath test to compare cerebral vascular reserve analysis and to evaluate of cerebrovascular Reserves differences.Result:The first chapter(1) Compared with low-risk group, high-risk group had significantly low scores in visual space and executive function, attention, calculation, ability of abstract and epitome, naming, memory, time direction (P<0.05);midrange-risk group had significantly low scores in function of visual space and executive, attention, calculation, ability of abstract and epitome, memory(P<0.05). High-risk group compared with midrange-risk group had significantly low scores in visual space and executive function, naming, calculation, language, time direction (P<0.05).With the dangerous increasing, the total score of MOCA among three groups were significantly reduced.(2) Light, medium and high risk group of right middle cerebral artery mean flow velocity was 61.18±13.29cm/s,66.79±21.93cm/s,08.75±87.24cm/s, there was significant difference in light risk group compared and the high risk group. Compared with the middle risk group, the average flow rate decreased significantly in the high risk group.(P <0.05).(3) The mean flow velocity in light, medium and high risk group of right middle cerebral artery was 56.36±11.13cm/s,51.50±16.22cm/s,78.25±44.67cm/s, the flow rate of anterior cerebral artery of the high-risk group had significantly lower than in the middle risk group;(4) proportion of abnormal TCD results (100%) in high-risk group was obviously higher than low-risk group (45.5%), which is mainly manifested in the high velocity and anomaly spectrum of middle cerebral artery, vertebral artery, and basal artery, (P<0.05). The proportion of abnormal TCD results (87.3%) in midrange-risk group was obviously higher than low-risk group (45.5%), which is mainly manifested in the high velocity of every cerebral artery. High-risk group compared with midrange-risk group had significantly high velocity and abnormal spectrum(P<0.05).The second chapter1. Under the quiet state, breath holding index (BHI) of vascular cognitive impairment group was significantly lower than the control group. Two groups of subjects after breath-hold, MCA peak velocity and average velocity have different levels of speed up, There was no significant difference in the breath-hold time of the two groups (P> 0.05); but the BHI of VCI group was significantly lower than the control group (P<0.05) control group.2. The pulsatility index (PI) and the resistance index (RI) decreased significantly after breath-hold (P<0.05);VCI group stroke volume index (PI) and resistance index (RI) decreased slightly after breath-hold, but the difference was not statistically significant (P> 0.05).Conclusion1. Cognitive impairment of ischemic cerebrovascular disease increased along with the more.risk2. With the more.risk factors, factors and the higher abnormal proportion of TCD, which priority to high velocity and abnormal spectrum of middle cerebral artery, vertebral artery and basal artery.3. Compared with normal group, the vascular reserve of ischemic VCI patients is significantly abnormal.