急性脑卒中发病后认知功能改变的患者MRS与MoCA得分相关性分析  

Correlation between MRS and MoCA Scores in Patients with Cognitive Impairment after Acute Stroke

作　　者：朱淼[1] 徐树军[1] 罗璇[1] 冯俊强[1] 刘娜[1] ZHU Miao;XU Shujun;LUO Xuan;FENG Junqiang;LIU Na(Department of Neurology,Daqing Longnan Hospital,Daqing 163000,China)

机构地区：[1]大庆龙南医院神经内科

出　　处：《医学综述》2020年第1期164-168,共5页Medical Recapitulate

基　　金：黑龙江省卫生计生委科研课题(2017-442)

摘　　要：目的探讨急性脑卒中发病后认知功能改变的患者磁共振波谱检查(MRS)与蒙特利尔认知评估量表(MoCA)得分的相关性。方法选取2015年3月至2017年8月大庆龙南医院收治的急性脑卒中患者97例,使用简易精神状态检查量表(MMSE)对患者认知功能障碍进行判断,将急性脑卒中合并认知功能障碍的患者纳入认知功能障碍组(54例),无明显认知功能障碍的患者纳入单纯脑卒中组(43例)。此外,选取同期体检的健康志愿者纳入健康对照组(30名)。对三组受试者分别进行MoCA评分,检测血清白细胞介素(IL)-1β、IL-6以及肿瘤坏死因子-α(TNF-α)水平,并进行MRS检查。结果认知功能障碍组患者MoCA评分显著低于单纯脑卒中组和健康对照组[(18.59±4.18)分比(27.58±1.22)分、(28.33±1.29)分](P<0.01),而单纯脑卒中组和健康对照组MoCA评分比较差异无统计学意义(P>0.05)。三组受试者MRS各项指标进行比较差异有统计学意义(P<0.01),其中认知功能障碍组左侧和右侧N/乙酰天门冬氨酸盐(NAA)/肌酸(Cr)显著低于单纯脑卒中组以及健康对照组(P<0.01),单纯脑卒中组左侧和右侧NAA/Cr显著低于健康对照组(P<0.01);认知功能障碍组左侧和右侧胆碱复合物(Cho)/Cr显著高于单纯脑卒中组以及健康对照组(P<0.01),单纯脑卒中组左侧和右侧Cho/Cr显著高于健康对照组(P<0.01)。三组受试者血清IL-1β、IL-6、TNF-α水平比较差异有统计学意义(P<0.01),其中认知功能障碍组患者显著高于单纯脑卒中组以及健康对照组(P<0.01),单纯脑卒中组显著高于健康对照组(P<0.01)。急性脑卒中认知功能障碍患者左侧和右侧NAA/Cr水平与MoCA呈正相关(r=0.632、0.555,均P<0.01),与血清IL-1β、IL-6以及TNF-α呈负相关(P<0.01);急性脑卒中认知功能障碍患者左侧和右侧Cho/Cr水平与MoCA呈负相关(r=-0.308、-0.396,均P<0.01),与血清IL-1β、IL-6以及TNF-α呈正相关(P<0.01)。结论MRS作为安全无创的影响�Objective To analyze the correlation analysis of the score of magnetic resonance spectroscopy(MRS)and the Montreal cognitive assessment scale(MoCA)in the patients with cognitive function changes after acute stroke.Methods From Mar.2015 to Aug.2017,97 patients with acute stroke admitted to Daqing Longnan Hospital were selected.Mini-mental state examination(MMSE)was used to judge the cognitive dysfunction of patients.The patients with acute stroke and cognitive dysfunction were included as a cognitive dysfunction group(54 cases),and the patients without obvious cognitive dysfunction were included as a simple stroke group(43 cases).In addition,30 healthy volunteers coming for health examination during the same period were included as a healthy control group.The three groups were scored by MoCA;the levels of serum interleukin(IL)-1β,IL-6 and tumor necrosis factor-α(TNF-α)were detected;and the MRS examination was done.Results The MoCA score of the cognitive dysfunction group was significantly lower than those of the simple stroke group and healthy control group[(18.59±4.18)score vs(27.58±1.22)score,(28.33±1.29)score](P<0.01),but there was no significant difference between the simple stroke group and the healthy control group(P>0.05).The differences of MRS indexes in the three groups were statistically significant(P<0.01),N-acetyl-aspartate(NAA)/creatine(Cr)in the left and right side of the cognitive impairment group was significantly lower than that in the simple stroke group and healthy control group(P<0.01),and that in the simple stroke group was significantly lower than that in the healthy control group(P<0.01);choline(Cho)/Cr of the left and right in the cognitive impairment group were significantly higher than those in the simple stroke group and the healthy control group(P<0.01),and that of the simple stroke group were significantly higher than that of the healthy control group(P<0.01).The levels of serum IL-1β,IL-6 and TNF-αin the three groups were significantly different(P<0.01),and those in the cognit

关 键 词：急性脑卒中 认知功能 磁共振波谱检查 蒙特利尔认知评估量表 相关性 

分 类 号：R741[医药卫生—神经病学与精神病学]