轻中度颅脑损伤患者认知功能障碍特征及危险因素  

Characteristics and risk factors of cognitive dysfunction in patients with mild and moderate traumatic brain injury

作　　者：程晓涛[1] 金保哲[1] 惠磊[1] 周文科[1] 

机构地区：[1]新乡医学院第一附属医院神经外科,河南卫辉453100

出　　处：《中华脑科疾病与康复杂志（电子版）》2016年第1期25-28,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：河南省教育厅自然科学研究计划资助项目(12A320012);河南省医学科技攻关计划资助项目(201203069);河南省卫生科技创新中青年人才项目(200692)

摘　　要：目的研究轻中度创伤性颅脑损伤(TBI)患者认知功能障碍的特点及相关危险因素,为早期诊断和采取有针对性的治疗及康复训练提供依据。方法前瞻性研究2014年9月至2015年9月新乡医学院第一附属医院收治的轻中度TBI患者102例,采用蒙特利尔认知评估量表(Mo CA)中文版评定其认知功能,根据评定结果分认知功能障碍组和无认知功能障碍组,分析年龄、性别、文化程度等因素与认知功能障碍之相关性;根据损伤部位不同分组,分析不同损伤部位患者之间认知功能障碍程度的差异。结果纳入研究的102例中,认知功能障碍74例(72.5%),认知功能障碍以视空间与执行功能、注意力、计算力、语言、抽象、延迟回忆等认知域为重(均P<0.01)。额叶、颞叶和基底节损伤的患者发生认知功能障碍的程度较其他部位严重(均P<0.05)。Logistic回归分析显示,文化水平、年龄是影响TBI后认知功能障碍的主要危险因素(均P<0.01)。结论额叶、颞叶和基底节部位损伤患者的认知功能障碍程度较重,文化程度、年龄是轻中度TBI后认知功能障碍的主要危险因素。Objective To research the characteristics and related risk factors of cognitive dysfunction in patients with mild and moderate traumatic brain injury （TBI）and provide basis for early diagnosis and targeted treatment and rehabilitation training of cognitive dysfunction. Methods A prospective study was performed on 102 patients with mild and moderate TBI from the First Affiliated Hospital of Xinxiang Medical University since September 2014 to September 2015. Montreal cognitive assessment （MoCA） of Chinese version was used to assess their cognitive function. The patients were divided into cognitive dysfunction group and non cognitive dysfunction group by the scores of the assessment. Correlation analysis of age, gender, educational level was performed in patients with and without cognitive dysfunction. Grouping the patients by the differences of damaged site, the differences of degree of cognitive dysfunction among patients with different damaged site were analyzed. Logistic regression analysis was further used to analyze the risk factors for cognitive dysfunction. Results In enrolled 102 patients,74 cases（72. 5% ）were identified with cognitive dysfunction. Cognitive dysfunction mainly manifested as visual-spatial and executive function, attention and calculation,language, abstract, and delayed memory （ all P 〈 0.01 ）. The patients with trauma in frontal lobe, temporal lobe and basal ganglia were more severe in terms of cognitive dysfunction than the other groups （all P 〈 0. 05 ）. Logistic regression analysis showed that educational level, age were the major risk factors for cognitive dysfunction after TBI （ all P 〈 0. 01 ）. Conclusion The patients with trauma in frontal lobe, temporal lobe and basal ganglia were more severe in terms of cognitive dysfunction. Educational level and age are mainly risk factors for cognitive dysfunction after TBI.

关 键 词：颅脑损伤 危险因素 认知功能障碍 

分 类 号：R749.12[医药卫生—神经病学与精神病学]