缺血性脑血管病并脑微出血相关因素分析及认知功能临床研究  

Clinical study on cognitive function and the related factors of patients with ischemic cerebral vascular disease complicated with cerebral microbleeds

作　　者：刘军贤[1] 王志东[2] 黄润霞[1] 

机构地区：[1]河北保定市第三中心医院内二科,保定071051 [2]河北遵化市人民医院神经内科,遵化064200

出　　处：《中国实用神经疾病杂志》2015年第11期3-6,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析缺血性脑血管病(ICVD)合并脑微出血(CMBs)的相关因素及对认知功能的影响。方法选取240例ICVD患者为研究对象,根据是否合并CMBs分为CMBs组和非CMBs组,分别纳入62例和178例患者,应用简易精神状况检查表(MMSE)和蒙特利尔认知评估量表(MoCA)评估患者的认知功能。结果 CMBs组患者的年龄、合并高血压比例、脑白质疏松(LA)比例、腔隙性梗死(LI)比例和既往卒中史比例均显著高于非CMBs组患者(P<0.05),高龄(OR=1.376)、合并高血压(OR=3.965)、合并LI(OR=3.562)是ICVD患者合并CMBs的危险因素(P<0.05);CMBs组MMSE总分、MoCA总分和视空间/执行、注意、延迟回忆等评分均显著低于无CMBs组(P<0.05),累及皮层-皮层下CMBs患者的MMSE总分、MoCA总分及视空间/执行、注意、语言、延迟回忆等评分均显著低于无累及皮层-皮层下CMBs患者(P<0.05)。结论 ICVD患者合并CMBs的发病与多种因素具有相关性,可导致患者出现显著的认知功能障碍,可能与累及皮层-皮层下CMBs病灶具有相关性。Objective To analyze cognitive function and the related factors of patients with ischemic cerebral vascular dis‐ease （ICVD） complicated with cerebral microbleeds （CMBs）. Methods 240 cases of ICVD patients were selected as the re‐search objects and were divided into CMBs group and non CMBs group according to whether complicated with CMBs. 62 pa‐tients and 178 patients were included respectively. Mini Mental State Examination （MMSE） and Montreal cognitive assessment scale （MoCA） were applied to evaluate and compare the cognitive function of the patients.Results The age and proportions of patients with hypertension ,leukoaraiosis（LA） ,lacunar Infarction （LI） ,a history of previous stroke in CMBs group were sig‐nificantly higher than those in non CMBs group （P〈0.05）. The age （OR=1.376） ,hypertension （OR=3.965） ,and LI （OR=3.562） were the risk factors for the incidence of ICVD patients complicated with CMBs （P〈 0.05）. The total score of MMSE ,the total score of MoCA score and the scores of visuospatial/executive ,attention ,delayed memory items of patients in CMBs group were significantly lower than those of the patients in non CMBs group （P〈0.05）. The total score of MMSE ,the total score of MoCA score and the scores of visuospatial/executive ,attention ,language ,delayed memory items of patients with CMBs involving the cortico subcortical areas were significantly lower than those without involving CMBs involving the cortico subcortical areas （P〈0.05）.Conclusion The incidence of ICVD complicated with CMBs is associated with many factors ,and can lead to significant cognitive impairment ,which may be related with the occurrences of CMBs lesion involving the cortico subcortical areas.

关 键 词：缺血性脑血管病 脑微出血 相关因素 认知功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]