脑微出血患者认知功能变化的临床观察  

Clinical observation on changes of cognitive function in patients with cerebral microbleeds

作　　者：张慧萍[1] 朱祖福[1] 洪珊珊[1] 陆强彬[1] 杨江胜[1] 周国庆[1] 姜岐涛[2] 

机构地区：[1]东南大学医学院附属医院神经内科,江阴214400 [2]东南大学医学院附属医院影像科,江阴214400

出　　处：《中华行为医学与脑科学杂志》2013年第11期1001-1003,共3页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的探讨脑微出血（cerebralmicrobleeds，CMBs）与认知功能变化之间的关系及CMBs引起认知功能障碍的可能机制。方法以头颅MR磁敏感加权成像（susceptibilityweightedimagine，SWI）技术见脑微出血灶者为病例组共68例，选取头颅SWI序列未见微出血灶患者68例符合入选标准者作为对照组，两组同时运用蒙特利尔认知评估量表（MoCA）、画钟试验（CDT）进行评估。结果CMBs组的CDT分值[（2．00±0．88）分]明显低于对照组[（3．76±0．53）分]，且差异有统计学意义（t=-3．27，P=0．00）。CMBs组的MoCA总分及执行功能、命名、计算、语言、概括抽象、记忆评分均明显低于对照组，且差异有统计学意义（t=-5．48，P=0．00；t=-4．36，P=0．00；t=-2．35，P=0．01；t=-2．49，P=O．02；t=-4．09，P=O．00；t=-4．63，P=0．00）；CMBs轻度、中度、重度组CDT分值、MoCA总分、执行功能、语言、抽象概括、记忆评分与对照组比较差异均有统计学意义（P〈O．05），CMBs轻度组、中度组、重度组语言、计算及执行功能（CDT反映）得分组间差异有统计学意义（P〈0．05）。CMBs数目与总分、执行功能、语言、抽象概括呈负相关（r=-0．675，P=0．000；r=-0．689，P=0．000；r=-0．536，P=0．000；r=-0．636，P=0．ooo）。结论CMBs是否存在及数目多少和患者认知功能损害密切相关，CMBs数目越多，认知功能损害越明显。Objective To investigate the relationship between the cerebral microbleeds （CMBs） and changes of cognitive function, and the possible mechanism of cognitive impairment caused by CMBs. Meth- ods Sixty-eight micro-hemorrhage patients on susceptibility weighted imagine （SWI） sequences composed posi- tive group, and sixty-eight patients selected without micro-hemorrhage in the SWI sequence and meeting the selec- tion criteria as control group. At the same time, both two groups were assessed by MoCA and CDT scale inspection. Results CDT scores of CMBs group （2.00±0.88） were significantly lower than those of control group （3.76± 0.53） , and there was significantly different in the two groups （ t=-3.27, P= 0.00）. At the same time, MoCA total scores and executive functions, naming, calculation,language, abstraction, recall scores of CMBs group were signifi- cantly lower than those of control group, and all of the groups were significantly different （ t=-5.48, P= 0.00; t=-4.36, P=0.00; t=-2.35, P=0.01 ; t=-2.49, P=0.02; t=-4.09, P=0.00; t=-4.63, P= 0.00）. CDT seores,Mo- CA total scores, executive functions,language, abstraction, memory scores between CMBs groups and control group were significantly different at all levels （P〈 0.05）. Executive functions , languages and calculated inter-group of mild CMBs ,moderate CMBs, severe CMBs were significantly different （P〈0.05）. The number of CMBs was nega- tive correlation with total scores, executive function, language, and abstract （ r= -0.675, P= 0.000; r= -0.689, P= 0.000; r=-0.536, P= 0.000; r=-0.636, P= 0.000）. Conclusion The existence of CMBs and the number of CMBs are closely related to cognitive dysfunction. The more of CMBs, the more of obvious cognitive impairment.

关 键 词：脑微出血 认知功能障碍 蒙特利尔认知评估量表 画钟试验 

分 类 号：R743.34[医药卫生—神经病学与精神病学]