基底节区腔隙性脑梗死患者认知功能障碍分析  

The study of cognitive deficit in patients with basal ganglia region lacuna infarction

作　　者：张剑平[1] 姜冬梅[1] 石国锋[1] 何萍[1] 李在望[1] 

机构地区：[1]南京医科大学附属无锡市人民医院神经内科,江苏南京210029

出　　处：《中风与神经疾病杂志》2017年第3期250-253,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的分析基底节区腔隙性脑梗死(lacuna infarction,LI)患者认知功能障碍的临床特征。方法收集基底节区LI患者120例(根据病灶数量分为少发组和多发组),以头部MRI正常的82例健康体检老年人为对照组,以认知能力筛查测验(中文2.0版)(CASI C-2.0)和事件相关电位P300(ERPs P300)作为认知评估工具,观察LI患者与对照组认知功能的差异。结果少发组LI患者CASI总分与对照组无明显差异(P>0.05),但少发组CASI子项目"近期记忆"和"定向感"均低于对照组(P<0.05)。多发组LI患者不仅CASI总分明显低于对照组(P<0.05),而且多个CASI子项目("近期记忆"、"集中及心算力"、"定向感"、"抽象推理"及"空间慨念")评分均低于对照组(P<0.05)。而多发组患者"近期记忆"、"定向感"及"空间概念"等子项目的评分与对照组的差异尤为明显(P<0.01)。少发组ERPs P300潜伏期与对照组无明显差异(P>0.05),而多发组ERPs P300潜伏期明显长于对照组(P<0.05)。结论基底节区LI患者认知功能明显下降,其中近期记忆、定向感及空间慨念等认知能力损害尤为明显。Objective To investigate the clinic characteristics of cognitive deficit in patients with basal ganglia region lacuna infarction（ LI）. Methods One hundred and twenty patients with basal ganglia region LI（ divided into few lesions group and multiple lesions group according to the number of lesions） and eighty two old people in physical examination by head MRI scan without abnormal（ control group） were enrolled. The differences of cognition ability were compared and analyzed between patient with basal ganglia region LI and control group using the Cognitive Abilities Screening Instrument,Chinese Version 2. 0（ CASI C-2. 0） and event related potentials P300（ ERPs P300）. Results There was no significant diference in CASI sum score between LI in few lesions group and control group（ P〉0. 05）,however,LI patients in few lesions group had a lower score on subdomains＂short-term memory＂and＂orientation＂than those of control group（ both P〈0. 05）. LI patients in multiple lesions group had a higher score not only on CASI sum score but also on CASI subdomains＂short-term memory＂,＂concentration or mental manipulation＂,＂orientation＂,＂abstraction and judgment＂and＂visual construction＂than those of control group（ all P〈0. 05）. Particularly,the performance of LI patients in multiple lesions group was obviously worse than the control group in the subdomains ＂short-term memory＂,＂orientation＂and ＂visual construction＂（ all P〈0. 001）. Compared to controls,LI patients in multiple lesions group exhibited longer P300 latency（ P〈0. 05）though there was no significant difference longer P300 latency detected between LI patients in few lesions group and control group（ P〉0. 05）. Conclusion Cognitive function of LI patients declined obviously,especially in items such as ＂shortterm memory＂,＂orientation＂and ＂visual construction＂.

关 键 词：腔隙性脑梗死 基底节区 认知功能障碍 

分 类 号：R743[医药卫生—神经病学与精神病学]