缺血性脑小血管病轻度认知障碍的危险因素  

Risk factors of mild cognitive impairment in patients with ischemic cerebral small vessel disease

作　　者：牛智领[1] 牛好敏[1] 刘远洪[1] 葛晓航[1] 郝静[1] 闫斌[1] 

机构地区：[1]河南省濮阳市人民医院神经内科,濮阳457000

出　　处：《临床医学》2014年第8期15-17,共3页Clinical Medicine

摘　　要：目的探讨缺血性脑小血管病所导致轻度认知障碍患者的危险因素,为早期诊断和早期干预提供依据。方法应用蒙特利尔认知评估量表(Montreal Cngnitive Assessment)筛查轻度认知障碍(MCI),收集相关危险因素,并进行神经心理学测试。根据MRI表现分为脑白质疏松(LA)、腔隙性脑梗死(LI)和LA与LI并存(LA+LI)3种类型。结果共纳入150例,其中MCI组70例,非MCI组80例,单因素分析显示,MCI组年龄、性别构成比与非MCI组比较差异无统计学意义,但受教育年限显著短于非MCI组[(9.06±4.46)岁vs(11.48±3.51)岁;t=-5.116,P<0.001],而高血压病(71.4%vs 45.0%;χ2=8.325,P=0.004)、糖尿病(55.7%vs 40.00%;χ2=4.801,P=0.028)、高脂血症(48.5%vs 23.7%;χ2=9.552,P=0.002)、颈动脉硬化(42.8%vs 18.7%;χ2=6.871,P=0.010)、吸烟(34.3%vs 13.8%;χ2=6.581,P=0.011)构成比及总胆固醇[(5.26±1.26)mmol/L vs(4.56±1.23)mmol/L;t=3.326,P=0.001]、尿酸[(351.81±83.21)mmol/L vs(323.03±80.43)mmol/L;t=2.102,P=0.0371]水平显著高于非MCI组。结论高血压病、糖尿病、高脂血症、颈动脉硬化、吸烟及教育水平较低是缺血性脑小血管病患者MCI的独立危险因素。Objective To investigate the risk factors of mild cognitive impairment（ MCI） in patients with ischemic cerebral small vessel disease（ SVD） and provide basis for early diagnosis and intervention. Methods Cognitive Assessment Scale（ MoCA） was used to screen MCI. The related risk factors were collected,and other neuropsychological tests were conducted. According to the MRI manifestation,the patients were divided into leukoaraiosis（ LA）,lacunar infarction（ LI）,and LA ＋ LI.Results A total of 150 patients withs SVD were enrolled（ 70 cases in MCI group,80 cases in non-MCI group）. Univariate analysis showed that there was no significant difference in ages or sex constituent ratio between the MCI and non-MCI group,but the years of education in MCI group was shorter than that in non-MCI group[（ 9. 06 ± 4. 46） years vs（ 11. 48 ± 3. 51） years; t =- 5. 116,P 0. 001],and the constituent ratio of hypertension（ 71. 4% vs 45. 0%; χ^2= 8. 325,P = 0. 004）,diabetes（ 55. 7%vs 40. 0%; χ^2= 4. 801,P = 0. 028）,hyperlipidemia（ 48. 5% vs 23. 7%; χ^2= 9. 552,P = 0. 002）,carotid atherosclerosis（42.8% vs 18.7%,χ^2= 6. 871,P = 0. 010）,smoking（ 34. 3% vs 13. 8%; χ^2= 6. 581,P = 0. 011） and the levels of total cholesterol[（ 5. 26 ± 1. 26） mmol /L vs（ 4. 56 ± 1. 23） mmol /L; t = 3. 326,P = 0. 001],uric acid[（ 351. 81 ± 83. 21） mmol /L vs（323.03 ± 80. 43） mmol/L; t = 2. 102,P = 0. 0371] in MCI group were significant higher than those in non-MCI group.Conclusion Ischemic cerebral sypertension,diabetes,hyperlipidemia,carotid atherosclerosis,smoking,and the low level of education are the independent risk factors for MCI in patients with SVD.

关 键 词：缺血性脑小血管病 轻度认知障碍 蒙特利尔认知功能评估量表 

分 类 号：R743[医药卫生—神经病学与精神病学]