急性缺血性卒中患者脑白质病变与认知功能障碍的相关性研究  

Study of the Correlation between the Cognitive Impairment and White Matter Changes in Patients with Acute Ischemic Stroke

作　　者：芦林龙[1] 冯涛[1] 刘萍[1] 张璇[1] 王雪梅[1] 王拥军[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,北京市100050

出　　处：《中国卒中杂志》2010年第11期882-887,共6页Chinese Journal of Stroke

摘　　要：目的研究急性缺血性卒中患者脑白质病变与认知功能障碍是否具有相关性。方法连续入选急性缺血性卒中急诊患者107例,用蒙特利尔认知评价量表(Montreal CognitiveAssessment,MoCA)进行认知评定,分别用Blennow、Fazekas及胆碱能通路白质量表(CholinergicPathways HyperIntensities Scale,CHIPS)等影像学量表进行脑白质病变测评,并讨论认知功能障碍与脑白质病变程度的相关性。结果 MoCA量表评分与Blennow量表评分有相关性(r=-0.300,P<0.01);MoCA量表评分与Fazekas量表评分总分无明显相关性(r=0.159,P>0.05);MoCA量表评分与CHIPS量表评分总分有相关性(r=0.316,P<0.01)。结论急性缺血性卒中患者脑白质病变的程度与认知功能障碍相关,CHIPS量表可能更具有有效性和可靠性。Objective To investigate the correlation between the cognitive impairment and leukoaraiosis in patients with acute ischemic stroke. Methods One hundred and seven emergency patients with acute ischemic stroke （onset within 7 days） were included in this study. The cognitive function was assessed with Montreal Cognitive Assessment （MoCA）. Two trained raters evaluated computer tomography （CT） and magnetic resonance imaging （MRI） scans using CT（Blennow） and MR1 （Fazekas and Cholinergic Pathways Hyperlntensities Scale [CHIPS]） rating scales for white matter changes. Correlations between the cognitive impairment and leukoaraiosis were evaluated. Results High correlations were observed between MoCA and Blennow and CHIPS rating scales （Spearman＇s coefficient were-0.300 and-0.316, respectively, P〈0.01）. There was no significant correlation between MoCA and Fazekas rating scale （Spearman＇s coefficient was-0.159, P〉0.05）. Conclusion The present findings support the view that a good correlation exists between the cognitive impairment and severity of white matter changes in patients with acute ischemic stroke. The MRI rating scale for white matter lesions, in cholinergic pathways, CHIPS rating scale, is effective, reliable and shows stronger correlations with cognitive performance.

关 键 词：脑梗死 脑白质病变 认知障碍 量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学]