急性脑梗死患者认知功能、脑白质损伤的评定及相关性研究  

Assessment of cognitive function in patients with acute brain infarction and its correlation with white matter lesions

作　　者：王翠棉[1] 刘红[1] 任王芳[1] 梁冬青[1] 陈国钱[1] 张旭[1] 

机构地区：[1]温州医学院附属第一医院神经内科,325000

出　　处：《浙江医学》2012年第10期798-801,共4页Zhejiang Medical Journal

摘　　要：目的 探讨简易精神状态测验量表（Mini-Mental Status Examination,MMSE）、蒙特利尔认知量表（Montreal CognitiveAssessment,MoCA）筛查急性脑梗死后患者发生认知异常的能力及认知损害情况;探讨脑白质损伤、脑白质内胆碱能通路损伤情况与认知损害间的相关性.方法 对88 例急性脑梗死患者予MMSE、MoCA 进行认知功能评定;完成颅脑磁共振成像（magneticresonance imaging,MRI）者予Fazekas 量表、胆碱能通路高信号评分量表（cholinergic pathways hyperintensities scale,CHIPS）测评.结果 MoCA 测评出认知异常者为83 例（94.32%）,而MMSE 仅为22 例（25.00%）;MoCA 测评两组间总分及各认知域比较在总分及视空间/ 执行功能、命名、语言、抽象、延迟记忆方面差异,且差异有统计学意义（P＜0.05）;MoCA 评分与Fazekas 量表评分、CHIPS 评分间存在相关性（r=-0.340,P=0.001;r=-0.343,P=0.001）.结论 MoCA 较MMSE 筛查急性脑梗死后认知功能损害发生率敏感性高;脑白质损伤、脑白质内的胆碱能通路损伤程度与认知功能间存在可能的相关性.Objective To assess the cognitive function in patients with acute brain infarction and its correlations with white matter lesions. Methods The cognitive status were assessed in 88 patients with acute brain infarction by Mini-Mental Status Examination, （MMSE） and Montreal Cognitive Assessment（MoCA）; the assessments by Fazekas scale and cholinergic pathways hyperintensities scale （CHIPS） were performed in patients undergoing cranial MRI scanning. Results The cognitive abnormality was detected in 83 cases （94.3%） by MoCA; meanwhile it was detected in 22 cases （25.0%） by MMSE. According to MoCA as- sessment, there were significant differences in total score, visuospatial/executive abilities, naming, abstract, language, delayed memory between patients with cognitive abnormality and those with normal cognition （P〈0＋05）. The scores of MoCA were nega- tively correlated with the Fazekas and CHIPS scores （r=-0.340, P=0.001; r=-0.343, P=0.00t）. Conclusion MoCA is more sensitive than MMSE in screening cognitive impairment after acute brain infarction; and there are negative correlations of cognitive function with the severity of white matter lesion and cholinergic pathway lesions in white matter.

关 键 词：脑梗死 认知损害 脑白质损伤 量表 

分 类 号：R743.33[医药卫生—神经病学与精神病学]