脑微出血对急性脑梗死患者认知障碍的影响  

Influence of cerebral micro-bleeds on cognitive impairment of acute cerebral infarction patients

作　　者：郭立军[1] 

机构地区：[1]河北省涿州市医院神经内科,河北涿州072750

出　　处：《中国医药导报》2016年第14期65-68,共4页China Medical Herald

摘　　要：目的探讨脑微出血对急性脑梗死患者认知障碍的影响。方法选取2012年1月~2014年1月涿州市医院神经内科收治的急性脑梗死患者155例,根据有无脑微出血（CMB）分为CMB组（81例）和非CMB组（74例）,采用蒙特利尔评估量表（Mo CA）评分评价患者急性期和治疗6个月后的认知功能变化,分析脑微出血与急性脑梗死患者认知功能的相关性。结果 CMB组在急性脑梗死急性期及卒中后6个月Mo CA得分均低于非CMB组（P〈0.05）,且卒中后6个月得分低于急性期（P〈0.05）。不同脑微出血分级患者急性期Mo CA得分1级（32例）〉2级（35例）〉3级（14例）（P〈0.05）,同级CMB患者卒中后6个月得分明显低于急性期（P〈0.05）。脑微出血分级与急性期Mo CA总分及视空间/执行、命名、抽象和定向评分呈负相关（P〈0.05）。卒中后6个月Mo CA总分及空间/执行、命名、记忆、注意、抽象、语言、定向、计算子项目指标均与患者CMB分级呈负相关（P〈0.05）。结论脑微出血能引起急性脑梗死患者认知功能障碍,认知功能损程度与脑微出血严重程度相关,随着病程延长,认知功能损害程度可进一步加重。Objective To discuss the influence of cerebral micro-bleeds on cognitive impairment of acute cerebral infarction patients. Methods From January 2012 to January 2014, in Department of Neurology, Zhuozhou Hospital, 155 acute cerebral infarction patients were selected and divided into CMB group（81 cases） and non-CMB group（74 cases）,accoding to with cognitive impairment or not. The cognitive impairment were assessed and compared by the Mo CA scale inspection on the acute phase and after treatment 6 months respectively on the acute cerebral infarction patients.Results The Mo CA scores of CMB group at acute phase and after treatment 6 months were lower than those of non-CMB group（P〈0.05）, and the scores after treatment 6 months were lower than those at acute phase（P〈0.05）. The Mo CA scores of different grades of CMB patients were different, grade 1（32 cases） grade 2（35 cases） grade 3（14cases）（P〈0.05）. The scores of CMB patients after treatment 6 months were lower than those at acute phase（P〈0.05）.General Mo CA scores and the scores of visualization/executive, name, abstract, orientation. after treatment 6 months had negative relationships with grade of CMB（P〈0.05）, general Mo CA scores and the scores of visualization/executive,name, memory, attention, abstract, language, orientation calculate had negative relationships with grade of CMB（P〈0.05）. Conclusion The incidence of CMB in patients with acute cerebral infarction can lead to significant cognition disorders. CMB was more serious, the cognition disorders will be more serious. And with the extension of time, cognition disorders in patients with CMB will aggravate.

关 键 词：急性脑梗死 脑微出血 认知障碍 磁共振成像 蒙特利尔认知评估量表 

分 类 号：R743.34[医药卫生—神经病学与精神病学]