卒中风险评估与血管性认知障碍的相关性  

Association of stroke risk profile and vascular cognitive impairment

作　　者：王晏雯[1] 蔡苗[1] 徐珊瑚[1] 金煜[1] 李雅国[1] 

机构地区：[1]浙江省杭州市浙江医院,杭州310013

出　　处：《中华行为医学与脑科学杂志》2015年第6期528-531,共4页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的 探讨Framingham卒中风险评估与危险因素相关性血管性认知障碍的关系.方法 选择浙江医院无明显卒中病史的患者184例,予以Framingham卒中风险评估（FSRP）分为低危组56例、中危组70例、高危组58例,应用蒙特利尔认知评估（MoCA）、听觉词语学习测验（AVLT）、数字符号测验、连线测验、数字广度测验和言语流畅性测验评估各危险分层患者的记忆力、注意力、执行功能和语言能力等各方面认知功能.结果 随着卒中危险程度的增加,低危组、中危组和高危组的MoCA总分[分别为（7.2±4.6）分、（13.8±3.9）分、（29.6±12.7）分]、AVLT延迟回忆得分[分别为（8.2±1.6）分、（6.7±1.4）分、（5.9±1.5）分]和数字符号测验成绩[分别为（34.7±9.3）个、（32.6±16.4）个、（29.7±13.6）个]依次递减,连线测验B耗时[分别为（115.2±36.9）s、（147.6±44.8）s、（173.9±58.5）s]逐渐增加,差异有统计学意义（P＜0.05）;FS-RP与认知功能相关,其中与MoCA、延迟回忆、数字符号测验、连线测验B、数字广度倒背呈负相关（P＜0.05）,与TMT-B耗时数呈正相关（P＜0.05）;多因素回归分析显示年龄、高血压、糖尿病和吸烟是血管性认知减退的危险因素（P＜0.05）.结论 年龄、吸烟、高血压和糖尿病是血管危险因素中对认知损害最重要的四个因素.随着卒中风险增高,血管危险因素可以导致认知功能的损害,其中延迟回忆和执行功能是两个主要受累的认知领域。Objective To investigate the correlation between Framingham stroke risk profile（FSRP） and vascular cognitive impairment in stroke-free patients with cerebrovascular risk factors.Methods One hundred and eighty-four stroke-free subjects,selected from Zhejiang hospital,were divided into low risk group （56 subjects）,moderate risk group （70 subjects） and high risk group （58 subjects） according to their FSRP score,and their cognitive function including memory ability,attention,executive function and language ability were assessed by Montreal cognitive assessment （MoCA）,auditory verbal learning test （AVLT）,digit symbol test,trail making test（TMT）,digit span and verbal fluency test.Results The total MoCA scores which were （7.2±4.6）,（13.8±3.9）,（29.6± 12.7） respectively,AVLT-delay recall scores which were（8.2± 1.6）,（6.7± 1.4）,（5.9± 1.5） respectively,and digit symbol test score which were（34.7±9.3）,（32.6± 16.4）,（29.7± 13.6） respectively in low,intermediate and high risk groups,decreased with the increasing risk of stroke（P〈0.05）.The elapsed time in TMT-B which were （115.2 ±36.9） s,（147.6±44.8） s,（173.9±58.5） s respectively in low,intermediate and high risk groups,prolonged with the increasing risk of stroke （P〈0.05）.FSRP was associated with cognitive function,but inversely related to MoCA,AVLT-delay recall,digit symbol test,TMT-B and digit span fall back （P〈0.05）,but positively related to consuming time in TMT-B （P〈 0.05）.Multivariate regression analysis showed that advanced age,hypertension,diabetes and smoking were the risk factors for vascular cognitive impairment（P〈0.05）.Conclusion Advanced age,smoking,hypertension and diabetes are the most important in vascular risk factors for cognitive impairment.Vascular risk factors can damage cognitive function with the increased risk of stroke,among which delayed recall and executive function are the main affected cognitive area.

关 键 词：血管性认知功能障碍 Framingham卒中风险评估 危险因素 

分 类 号：R749.13[医药卫生—神经病学与精神病学]