无症状性脑梗死合并抑郁选择注意功能的研究  

A study of the selective attention function of patients with silent cerebral infarction and depression

作　　者：危薇[1] 汪静秋[1] 罗华[1] 徐志彬[1] 段小东[2] 何传兵[1] 

机构地区：[1]泸州医学院附属医院神经内科,泸州646000 [2]泸州医学院附属医院康复科

出　　处：《中国神经精神疾病杂志》2013年第11期662-666,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：泸州医学院青年基金(编号:泸医院科【2012】2号)

摘　　要：目的探讨无症状性脑梗死(silent cerebral infarction,SCI)合并抑郁患者选择注意功能损害的特点,抑郁与选择注意及与认知功能障碍的关系。方法选择SCI患者(SCI组)、无SCI的抑郁症患者(无SCI抑郁组)和正常人(对照组)各82例,采用汉密尔顿抑郁(Hamilton Depression Rating Scale,HAMD)量表、蒙特利尔认知评估(Montreal cognitive assessment,MoCA)和Stroop色词测验(Stroop color-word test,CWT)进行评价,SCI患者再根据HAMD得分分为抑郁组和非抑郁组。结果 SCI组MoCA评分为(23.11±5.41),较对照组(28.70±2.18)降低,其中抑郁组为(20.31±5.44),降低更为明显(均P<0.01)。与对照组相比,SCI组的任务A、B、C和Stroop干扰效应(Stroop interference effects,SIE)耗时延长(P<0.01),其中抑郁组为(33.25±14.10)、(42.45±15.18)、(104.68±25.08)、(62.24±21.53)秒;SCI组的任务B、C和SIE错误数增多(P<0.05),抑郁组为(3.59±2.14)、(15.67±7.20)、(12.08±6.46),抑郁组变化最为明显。其MoCA评分与SIE耗时和错误数呈负相关(r=-0.429,r=-0.500,均P<0.01)。梗死灶位置与HAMD评分和SIE错误数有一定关系:两者得分左侧梗死组高于右侧梗死组,皮质梗死组SIE得分高于皮质下梗死组,而HAMD评分相反。结论 SCI合并抑郁的患者选择注意功能有明显损害,且与认知功能水平具有良好的相关性。Objective To explore the characteristics of selective attention function in patients with silent cerebral infarction （SCI） and depression, the relationship between depression, selective attention and cognitive dysfunction. Methods Eighty-two patients with SCI and 82 normal subjects were selected and evaluated by using Hamilton Depression Rating Scale （HAMD）, Montreal cognitive assessment （MoCA） and Stroop color-word test （CWT）. Patients with SCI were further classified into depression subgroup and no-depression subgroup based on the score of HAMD. Results The score of MoCA was lower in SCI group （23.11±5.41） and was much lower in depression subgroup （20.31±5.44） compared with control group （28.70±2.18） （all P〈0.01）. Compared with control group, the reaction times of card A, B, C and Stroop interference effects （SIE） were prolonged in SCI group. The reaction time of card A, B, C and SIE were （33.25±14.10）; （42.45± 15.18）; （104.68±25.08） and （62.24±21.53） in depression subgroup, respectively. The error counts of card B, C and SIE were increased （P〈0.05） in SCI group. The error counts of card B,C and SIE were （3.59±2.14）, （15.67±7.20） and （12.08± 6.46） in depression subgroup, respectively. The scores of MoCA were negatively correlated with the reaction time and error counts of SIE （r =-0.429,r =-0.500,all P〈0.01）.The location of infarction was correlated with the score of HAMD and error counts of SIE to some degree： both of the scores were higher in patients with left infarction compared with right infarction and were higher in patients with cortex infarction compared with subcortex infarction. Conclusion The present study revealed that patients with SCI and depression have selective attention deficit which is closely correlated with the level of cognitive function.

关 键 词：无症状性脑梗死 抑郁 认知功能障碍 选择注意功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]