Study On The Correlation Between Cognitive Impairment And Blood Lipid Level After White Matter Lessions And Its Distribution Of TCM Syndromes

Objectives:To study the distribution of TCM syndromes of cognitive impairment after isc hemic white matter lessions,the effect of WML on cognitive function,and the correlatio n between hdl-c,ldl-c,ApoB and cognitive impairment after WML.Methods:80 cases of WML patients with cognitive impairment and 20 cases of WML pat ients with normal cognition in the department of encephalopathy,nanjing hospital of tradi tional Chinese medicine were selected,and 20 cases of healthy physical examination with out risk factors of cerebrovascular diseases were selected as the normal control group.B asic information of patients,data of the four traditional Chinese medicine diagnosis and s erum hdl-c,ldl-c and ApoB values were collected,and the cognitive function of WML p atients was scored using the Chinese version of the MoCA scale.The syndrome types of patients in the WML cognitive impairment group were identified according to the TCM syndrome classification scale.Firstly,the distribution of TCM syndromes of WML cogni tive impairment was discussed.Secondly,patients with WML were divided into different parts and degrees according to head MRI to explore the effects of different parts and de grees of WML on cognitive function.Finally,the general data and serum hdl-c,ldl-c and ApoB levels of the cognitive impairment group and the normal group were analyzed to explore the correlation between them and WML cognitive impairment.Results:The distribution of TCM syndromes of cognitive disorders was from high to low:26 cases(32.50%)of phlegm turbidity obstruction syndrome,18 cases(22.50%)of defi ciency of kidney essence syndrome,15 cases(18.75%)of deficiency of qi and blood,12 cases(15.00%)of hyperactivity of liver Yang syndrome,and 9 cases(11.25%)of blood stasis obstruction syndrome.The cognitive impairment group was divided into PVL grou p and DWML group by location.The scores of both groups were lower than those of th e normal control group(P<0.05)in the total MoCA score and each cognitive field.Th ere were no statistically significant differences between PVL and DWML groups in total MoCA scores,visual space and executive power,naming,abstraction,delayed recall and directed evaluation(P>0.05).The scores of attention,calculation and language of PVL group were all lower than that of DWML group(P<0.05).Cognitive impairment was d ivided into groups according to degree,and the scores of each group were all lower tha n those of the normal control group(P<0.05)in total MoCA score,visual space and e xecutive power,naming,attention,calculation,abstraction,delayed recall,and orientation.The MoCA total score,attention and named evaluation were compared among groups,an d the score of the severe group was lower than that of the mild and moderate groups(P<0.05).There was no statistically significant difference between the mild,moderate and severe groups(P>0.05).There was no significant difference between visual space,exe cutive power,abstraction and delayed memory(P>0.05).The score of the severe group was lower than that of the mild group,and the difference was statistically significant(P<0.05).The difference between the moderate and severe groups was not statistically si gnificant(P>0.05).The language score showed that there was no statistically significant difference between the mild group and the normal control group(P>0.05),while the moderate and severe group was lower than the normal control group(P<0.05).The dif ference between the mild group and the severe group was statistically significant(P<0.05).There was no statistically significant difference between moderate and severe(P>0.05).Conclusion:1.The distribution of TCM syndromes of cognitive impairment in WML rang ed from high to low,which were phlegm turbidity obstruction syndrome,deficiency of ki dney essence,deficiency of qi and blood,hyperactivity of liver Yang and blood stasis ob struction syndrome.2.WML can affect visual space and executive ability,abstraction and delayed memory,but severe WML affects the whole cognitive domain.The degree of WML was positively correlated with the level of cognitive impairment.WML in different parts of the brain can lead to cognitive decline,and PVL has a greater impact on atten tion,calculation and language.3.Cognitive impairment in patients with WML was associ ated with advanced age and decreased HDL cholesterol.