| objectives：In recent years,the number of our patients with CKD hasincreased year by year due to medical conditions and the improvement andreform of the health insurance system,the number of the health insurancesystem,the number of our line maintenance hemodialysis patients,and thesurvival time was significantly longer.Our line maintenance hemodialysispatients number corresponding incerease significantly longer survival time.Inpatients with chronic renal failure,the most important is not just to maintainthe survival time of the patients,it is more important to improve the quality oflife of these patients,Therefore,the state of maintenance hemodialysis patientswith cognitive function clinical attention.Cognitive impairment not onlydirectly affect the patient’s quality of life and increase the patient’shospitalization rates and mortality.Studies abroad confirmed in maintenancehemodialysis parients more prone to cognitive impairment,compared withnon-dialysis chronic kidney disease patients.Mild cognitive impairment(mildcognitive impairment,MCI):aging and dementia research areas recentlyproposed concept in six areas of memory,executive ability,attention,orientation,visuospatial ability,language ability,there were two or more thantwo areas of the defects of cognitive ability,educational attainment of the sickpatient age does not match,can also be referred to as cognitive dysfuction,mildmemory also can be broadly defined as the elderly or the item cognitivedysfunction,but still not enough to diagnose as the clinical phenomenon ofdementia.Therefore,mild cognitive impairment is a transitional state betweennormal elderly people with Alzheimer’s disease(AD) or other dementia.Studies show that each year12to15%of patients with MCI will developdementia, however, pathological anatomy and neuroimaging studies haveshown that AD and MCI patients had white matter change.White matter degeneration，now that is most likely to microvascular disease chronichypoperfusion lead.A recent study found that the ultrastructure hypoxia andischemic strong correlation between neuropathological findings. White matterdisease may have greater clinical significance than cortical.The conventionalMRI morphological displayed mainly microscopic changes in the white matterfibers can not provide the information,Diffusion tensor imaging (DTI)，Byobserving the diffusion of water molecules fractional anisotropy (fractionalanisotropy, FA) provide quantitative indicators for the assessment of theextent of damage.DTI’s emergence makes in vivo, non-invasive study ofcerebral white matter fiber ultrastructure, only in vivo nerve fiber bundlesrunning, arranged in the direction of high-end quality information technology，The technology is expected in the routine examination showed normal,reflecting the abnormal changes of white matter fiber.，The domestic use ofhigh-field MRI the DTI technology research MCI reported this study, DTI isan exploratory study the diagnostic value of maintenance hemodialysispatients.Methods：Select line maintenance hemodialysis patients29called theexperimental group in the Third Hospital of Hebei Medical University,MRIunits at the Third Hospital of Hebei Medical line routine examination18werenormal control group.Application SIEMENS3.0T MRI instrument cranialDTI scan，Were compared conventional image change, outlined14bilateralhemisphere ROIs (region of interest, ROI)，Measure the anisotropy (fractionalanisotropy, FA), the relevant comparison is the DTI data obtained FA valuedifferences.Results: DTI image analysis, the experimental group of the left frontalwhite matter (P=0.023), left occipital lobe white matter (P=0.01), the righthippocampus area of white matter (P=0.01),FA values lower than the controlgroup, the difference was statistically significant.Conclusion: frontal white matter, occipital white matter, white matter ofthe hippocampus may be involved in maintenance hemodialysis patients withcognitive impairment pathophysiological process changes. |
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