| Objective: CSVD is a disease of cerebral vascular lesion,It includes small artery,venules,arteriole and the capillaries.But it is generally accepted that CSVD is actually cerebral arteriole disease.From the angle of neuroimaging,CSVD is consist of lacunar infarction,white matter lesion,cerebral microbleeds and Virchow-robin spaces,Due to the more and more morbidity,CSVD is gradually paid high attention by the medical community.CSVD can result in varying degrees of cognitive dysfunction.At present,with the rapid development of the head nuclear magnetic field and imaging application,People will have a more and more understanding of the pathogenesis,pathophysiology,the risk factors,the clinical characteristics,treatment and prevention of CSVD.The recent studies have found that hypertension is closely related to CSVD.Therefor,our research aims to know the relation between CSVD and congnitive,through controlling the blood pressure smoothly,observing the effect of BP on congnitive.Methods:From March 2012 to December 2017,a total of 94 patients with CSVD combined hypertension and 43 patients with hypertension only,who were admitted to the Second Affiliated Hospital of Hebei Medical University,Department of Neurology were enrolled in the study.Recorded the basic clinical datum of all the patients,including age,gender,height,weight,education years,previous medical history of hypertension,diabetes,smoking history,imaging datum(including MRI+MRA+DWI+SWI),the result of 24 h ambulatory blood pressure monitoring(ABPM),biochemical information,electrocardiogram,carotid artery ultrasound,MMSE score,MoCA score and so on.Then analyzing the cognitive scores between patients with CSVD combined hypertension and patients with hypertension only.The patients with CSVD combined hypertension would be followed by telephone calls or outpatient services,at the first month,the third month,and the twelfth month,consulting the condition of anti-hypertension drug taking,the control level of blood pressure and the recurrence of stoke.If the control level of blood pressure was not ideal,guide the adjustment of anti-hypertension drug,to stable blood pressure level at 130-140/80-90 mmHg.At the end of two-year follow-up,Imaging datum(including MRI+MRA+DWI+SWI),24 h ambulatory blood pressure monitoring(ABPM),electrocardiogram,carotid artery ultrasound,MMSE score,MoCA score were examined.Results:1.The research included 94 patients with CSVD combined hypertension and 43 patients with hypertension only,and 30 patients finished two-year follow-up,In the CSVD combined hypertension group,38-75 years old,38 cases(40.43%)were female,the average age was 57.16±7.34,56 cases(59.57%)were male,the average age was 56.75±8.32,The control group,15 cases(34.88%)were female,the average age was 57.87±10.93,and 28 cases(65.12%)were female,the average age was 59.28±8.38,The finishing two-year followup group,17 cases(56.67%)were male,the average age was 56.47±6.38,13 cases(43.33%)were female,the average age was 57.54±5.14.The basic clinical datum between these groups were not statistically significant(P>0.05).2.In the CSVD combined hypertension group,The MMSE score and MoCA score were respectively 28.17±2.32 25.69±2.87.The control group,29.18±0.91 and 27.12±2.93.The finishing two-year follow-up group,28.30±1.47 and 25.73±2.23.Comparing CSVD combined hypertension group with the control group,the MMSE score and MoCA score,the difference were statistically significant(P<0.05),Comparing CSVD combined hypertension group with finishing two-year follow-up group,the difference were not statistically significant(P>0.05).3.There was still some deficiencies in this research,the case numbers were still not enough,and we still need a control group to compare with the group of finishing two-year follow-up,we still have many things to do to perfect the reseach.4.The research is still ongoing,from now on,the two-year follow-up cases are 30,the one-year follow-up cases are75,and the follow-up is in progress.During the follow-up,one case dead,one out of the research because of recurrent stroke and prolonging on bed.The other patients of the research were stably pressure controlled,there were not stroke recurrent.Conclusion:1.The CSVD patients have a higher risk of cognitive impariment.2.Through stably controlling pressure,the cognitive of the CSVD patients have a good control,with no further progressing. |
