部分前循环脑梗死与遗忘型轻度认知功能损害患者认知功能的对比研究  

The study on cognitive functions of patients with partial anterior circulation infarct and amnesic mild cognitive impairment.

作　　者：张美燕[1] 杨琼[2] 于欣[1] 刘娜[2] 樊东升[2] 王华丽[1] 

机构地区：[1]北京大学精神卫生研究所记忆障碍诊疗和研究中心卫生部精神卫生学重点实验室,北京100191 [2]北京大学第三医院神经科

出　　处：《中国神经精神疾病杂志》2011年第5期298-302,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金(编号:30500178);科技部高新技术发展项目(编号:2007AA02Z421);首都医学发展基金(编号:2005-1007)

摘　　要：目的比较部分前循环脑梗死(partial anterior circulation infact,PACI)和遗忘型轻度认知损害(amne-sic mild cognitive impairment,aMCI)患者的认知损害的特点。方法选择29例符合牛津社区卒中项目(Oxford Com-munity Stroke Droject,OCSP)分型的PACI患者,35例符合Petersen诊断标准的aMCI患者,以及60例健康老年人为对照组,采用认知功能筛选测验-C2.1(Cognitive Ability Screening Instrument-C2.1,CASI)评定认知功能。结果 PA-CI组(86.28±12.04)和aMCI组(89.86±6.03)的CASI总分均比正常对照组(95.57±3.44)低,差异具有统计学意义[F(2)=8.547,P<0.05],而PACI组与aMCI组间无统计学差异。在CASI分领域方面,与对照组相比,PACI组在心算力(P=0.000)和定向力(P=0.021)两方面均较差;与aMCI组比较,PACI组的心算力(P=0.000)较aMCI组差,而短时记忆(P=0.016)和思维流畅性(P=0.005)方面则较好。aMCI组与对照组相比,在短时记忆(P=0.000)、抽象与判断能力(P=0.013)和思维流畅性(P=0.001)方面均较差。结论 PACI患者存在认知损害,尤其在心算力和定向力方面,与aMCI患者相比,可能更好地保留了执行功能,推测缺血性脑卒中与神经退行性变引起的认知损害可能涉及不同认知领域。Objective Cerebral ischemia increases the risk of vascular cognitive impairment.The study aimed to compare the cognitive function of patients with partial anterior circulation infarct（PACI） and amnesic mild cognitive impairment（aMCI）.Methods Twenty-nine patients meeting the classification criteria of PACI by Oxford Community Stroke Project（OCSP）,35 individuals with aMCI by Petersen criteria,and 60 healthy elderly controls were enrolled in this prospective study.Cognitive functions were assessed by Cognitive Ability Screening Instrument-C2.1（CASI） within 1 month after diagnosis.The scores of nine cognitive domains in CASI and the total score of CASI were used for comparisons.Age,education and gender were entered as covariates in the general linear model for comparisons.Results Compared with control group（95.57±3.441）,the total scores of CASI were significantly lower in PACI（86.28±12.041） and aMCI groups（89.86±6.030）（F（2）=8.547,P0.05）.There was no significant difference in CASI total score between PACI and aMCI groups（P0.05）.The scores of attention（P=0.000） and orientation（P=0.021） were markedly lower in PACI group when compared with NC group.Compared with aMCI group,the score of mental calculation（P=0.000） was significantly lower in PACI group.Compared with control group,scores of short-term memory（P=0.000）,abstract thinking and judgment（P=0.013）,and category fluency（P=0.001） were lower in aMCI group.The score of short-term memory（P=0.016）and category fluency（P=0.005） were also lower in aMCI group than PACI group.Conclusions Individuals with PACI present marked cognitive impairment,especially in attention and orientation.In comparison with aMCI individuals,PACI individuals may preserve executive function as measured with category fluency.The findings suggest that cerebral ischemia-induced cognitive impairment may be in different domains from those induced by neurodegenerative diseases.

关 键 词：脑梗死 认知损害 遗忘型轻度认知损害 认知功能 

分 类 号：R749.1[医药卫生—神经病学与精神病学]