2023 年第 1 期 第 18 卷

帕金森病合并高血压患者大脑灰质体积的改变

Grey matter volume changes in patients of Parkinson′s disease complicated with hypertension

作者：李瑛徐磊

英文作者：Li Ying Xu Lei

单位：首都医科大学附属北京安贞医院医学影像科，北京100029

英文单位：Department of Radiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：帕金森病；高血压；灰质体积

英文关键词：Parkinson′sdisease;Hypertension;Greymattervolume

• 摘要：

• 目的  观察帕金森病合并高血压患者大脑灰质体积的改变。方法 选取首都医科大学附属北京安贞医院2017年3月至2020年5月收治的帕金森病患者65例，其中40例未合并高血压（非高血压组）、25例合并高血压（高血压组）。记录患者的人口统计学数据、统一帕金森病评定量表Ⅲ（UPDRS Ⅲ）评分、Hoehn & Yahr分期（H-Y分期）、蒙特利尔认知评估量表（MoCA）评分、老年抑郁量表（GDS-30）评分以及神经心理学量表评分。收集全脑T1磁共振成像图，基于体素的形态学方法提取灰质体积，分析2组灰质体积差异有统计学意义的脑区。结果 高血压组男性比例低于非高血压组（P＜0.05）。2组年龄、受教育年限、UPDRS Ⅲ评分、H-Y分期、GDS-30评分、MoCA评分、神经心理学量表评分比较差异均无统计学意义（均P＞0.05）。高血压组右侧颞上回、右侧楔前叶灰质体积均小于非高血压组［（0.46±0.01）比（0.53±0.01）、（0.35±0.01）比（0.41±0.01）］，差异均有统计学意义（均P<0.01）。偏相关分析结果显示，在非高血压组中，右侧颞上回灰质体积与视空间功能评分呈正相关（r=0.428，P=0.006），右侧楔前叶灰质体积与MoCA评分呈正相关（r=0.351，P=0.026）；在高血压组中，右侧颞上回灰质体积与视空间功能评分呈负相关（r=-0.424，P=0.035）。结论 帕金森病合并高血压患者右侧颞上回和右侧楔前叶灰质体积均小于未合并高血压的患者，并且与视空间和整体认知功能损害有关。

• Objective To investigate the changes of gray matter volume in patients of Parkinson′s disease (PD) complicated with hypertension. Methods From March 2017 to May 2020, 65 patients of PD were enrolled from Beijing Anzhen Hospital, Capital Medical University, including 40 cases without hypertension (non-hypertension group) and 25 cases complicated with hypertension (hypertension group). Demographic data, Unified Parkinson′s Disease Rating Scale Ⅲ (UPDRS Ⅲ) score, Hoehn & Yahr stage (H-Y stage), Montreal Cognitive Assessment (MoCA) score, Geriatric Depression Scale-30 (GDS-30) score, and neuropsychological scale score of patients were recorded. The T1 magnetic resonace imaging images of the whole brain were collected and the gray matter volume was extracted by voxel based morphological method. The brain regions with statistically significant difference in gray matter volume between the two groups were analyzed. Results The rate of male in hypertension group was lower than that in non-hypertension group (P<0.05). There were no differences in age, years of education, UPDRS Ⅲ score, H-Y stage, GDS-30 score, MoCA score, and neuropsychological scale score between the two groups (all P>0.05). The gray matter volumes of the right superior temporal gyrus and the right precuneus lobe in hypertension group were smaller than those in non-hypertension group ［（0.46±0.01） vs （0.53±0.01）,（0.35±0.01） vs （0.41±0.01）］(both P<0.01). Partial correlation analysis showed that in non-hypertension group, the gray matter volume of the right superior temporal gyrus was positively correlated with visuospatial function score (r=0.428, P=0.006), and the gray matter volume of the right precuneus lobe was positively correlated with MoCA score (r=0.351, P=0.026); in hypertension group, the gray matter volume of the right superior temporal gyrus was negatively correlated with visuospatial function score (r=-0.424, P=0.035). Conclusion The gray matter volumes of the right superior temporal gyrus and the right precuneus lobe in patients of PD complicated with hypertension are smaller than those in patients without hypertension, which is related to visuospatial and global cognitive impairment.