无症状腔隙性脑梗死患者认知功能和情感障碍的观察  

Study of cognitive function and emotional disorders in asymptomatic patients with lacunar cerebral infarction

作　　者：白鹤 董丽红 侯敏 

机构地区：[1]新疆自治区第二济困医院神经内科,乌鲁木齐830011

出　　处：《新疆医学》2016年第8期954-956,959,共4页Xinjiang Medical Journal

基　　金：院级课题基金(DEJKYY-201506)

摘　　要：目的探讨无症状腔隙性脑梗死患者的记忆功能障碍和情感障碍。方法随机选取2015年1月至2015年12月本院住院患者中无症状腔隙性脑梗死患者30例。设立对照组:同期同一医院收集的自愿参加试验的影像学无异常,临床神经查体正常者30例,经排除标准筛选后,对两组样本分别进行量表检查([1]),对两组样本分别进行认知功能量表检查(中文版简易精神检查量表MMSE量表)、社会功能活动及日常生活能力量表检查(BBS量表)、汉密尔顿抑郁量表(HAMD),汉密尔顿焦虑量表(HAMA)检查;神经系统体格检查以及CT检查。结果本研究得出以下研究结果:无症状腔隙性脑梗死MMSE评定总分与对照组比较有差异(P<0.05),BBS评分无差异(P>0.05),HAMD、HAMD评分有差异(P<0.05);MMSE各分项目评分中近记忆力及注意、计算力与对照组比较有显著差异(P<0.01)。无症状IE认知缺损Hachinski缺血指数均大于7分,符合血管源性认知缺,突出表现是记忆障碍,注意力,计算力下降,同时情绪、焦虑抑郁人数也较正常对损的界定值。无症状腔隙性脑梗死患者可能合并存在认知功能障碍照组高。结论无症状腔隙性脑梗死往往难以确定其确切发病时间,其后发生认知缺损时间长短不一,其发生记忆障碍、情绪状态异常高于对照组。应重视无症状腔隙性脑梗死认知障碍,情感障碍及早诊断及时治疗,预防血管性痴呆、卒中后抑郁的发生。Objective To investigate memory dysfunction and emotional disorders of asymptomatic patients with lacunar cerebral infarction. Methods 30 asymptomatie patients with lacunar cerebral infarction in our hospital from January 2015 to December 2015 were randomly selected. 30 volunteers in the same period with normal imaging were collected as control group. After being examined through exclusion standard screening scale, two groups were examined through the following examination, asymptomatie lacunar cerebral MMSE examination, neurological examination and CT examination. Results There were significant difference in MMSE scores between two groups （P 〈 0.05）. There were no difference in BBS score between two groups （P 〉 0.05）, but there were differences in HAMD scores between them （P 〈 0.05）; In MMSE examination, recent memory and attention, computing power in patients compared with control group were significantly different （P 〈 0.01）. Asymptomatic IE cognition impairment Hachinski index were greater than 7 points. It was consistent with vascular genesis of cognitive deficiency. Its prominent manifestation x^as declining memory, attention, ahihty of calculation combined with abnorrnal mood and anxiety depression. Asymptomatic patients with lacunar cerebral infarction may be combined with high cognitive dysfunction. Conclusion Asyrnptomatic lacunar cerebral infarction is often difficult to be determined its exact onset time, subsequent cognitive impairment is differ, the memory disorders, abnormal emotional state in patients is higher than those in control group. Cognitive impairment caused by asymptomatic lacunar cerebral infarction should be valued and emotional disorders need to be diagnosed early and treated timely in order to prevent vascular dementia and depression after stroke.

关 键 词：无症状腔隙性脑梗死 认知功能 情感障碍 血管性痴呆 卒中后抑郁 

分 类 号：R743.3[医药卫生—神经病学与精神病学]