不同部位急性脑梗死的认知功能障碍特点分析  

Characteristics of cognitive impairment of different infarct locations among patients after acute ischemic stroke

作　　者：宓特 屈传强[1] 王翔[1] 孙钦建[1] 孙昊[1] 杜怡峰[1] 

机构地区：[1]山东大学附属省立医院神经内科,济南250021

出　　处：《中华医学杂志》2016年第15期1205-1207,共3页National Medical Journal of China

基　　金：国家自然科学基金（30970991）;山东省自然科学基金（Y2007C043）;山东省重点研发计划（2015GSF118069）

摘　　要：目的 全面分析急性脑梗死不同部位认知特点,为临床早期防治血管性认知功能障碍提供理论依据.方法 收集2014年7月至2015年1月山东省立医院神经内科住院治疗的急性脑梗死患者105例,并行简易智能精神状态检查（MMSE）和蒙特利尔认知评估（MoCA）量表评分,统计分析不同梗死部位认知域损害特点.结果 急性脑梗死患者存在认知功能障碍.MMSE评分示受损显著的认知域有：左侧大脑梗死的图形执行力（P =0.027）,额叶梗死的语言复述（P =0.003）,顶叶梗死的短时记忆（P=0.04）和语言复述（P =0.007）;MoCA评分示受损显著的认知域有：额叶梗死的语言（P =0.002）、命名（P=0.011）、注意力（P =0.028）和时间定向（P=0.031）功能;顶叶梗死的记忆（P＜0.001）、注意力（P =0.041）、语言（P =0.049）和视空间与执行能力（P=0.049）;颞叶梗死的注意力（P=0.045）;基底节区梗死的语言功能（P =0.009）和时间定向（P =0.026）.结论 脑梗死急性期患者普遍存在认知功能障碍,不同部位梗死后认知受损特点不同,全面评估急性脑梗死后认知功能意义重大.Objective To investigate the characteristics of cognitive function changes of different infarct sites among patients after acute ischemic stroke,so as to provide theoretical basis for preventing and treating vascular cognitive dysfunction.Methods One hundred and five cases of acute ischemic stroke within fourteen days meeting the standard set were enrolled,and they were tested by Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA）.And the characteristics of cognitive changes with different infarction sites were analyzed.Results Patients with acute stroke suffered cognitive impairment.The significantly impaired cognitive domains in MMSE were：graphics execution in patients with left hemisphere infarction （P =0.027）;verbal repetition in frontal infarction （P =0.003）;short memory （P =0.04） and verbal repetition （P =0.007） in parietal infarction.The significantly impaired cognitive domains in MoCA were：language （P =0.002）,naming （P =0.011）,attention （P =0.028） and time orientation （P =0.031） in frontal infarction;delayed memory （P ＜ 0.001）,attention （P =0.041）,language （P =0.049） and visual space and executive ability （P =0.049） in parietal infarction;attention in temporal infarction （P =0.045）;language （P =0.009） and time orientation （P =0.026） in basal ganglia region infarction.Conclusion Most ischemic stroke patients at acute phase suffered cognitive impairment and the characteristics of cognitive changes differed according to different infarction sites.Comprehensive assessment of cognitive impairment after acute stroke is of great importance.

关 键 词：脑梗死 急性期 血管性认知功能障碍 

分 类 号：R749.13[医药卫生—神经病学与精神病学]