大动脉粥样硬化性非致残性缺血性脑血管病患者认知功能减退的相关因素分析  

Analysis on the risk factors of cognitive impairment in patients with large arteriosclerotic non-disabling ischemic cerebrovascular events

作　　者：史俊 孙美 黄琳[2] 程虹[2] SHI Jun;SUN Mei;HUANG Lin;CHENG Hong(Department of Neurology,Jiangsu Province Hospital Liyang Branch,Liyang,Jiangsu 213300,China;Department of Neurology,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029)

机构地区：[1]江苏省人民医院溧阳分院神经内科,江苏溧阳213300 [2]南京医科大学第一附属医院神经内科,江苏南京210029

出　　处：《徐州医科大学学报》2020年第4期245-249,共5页Journal of Xuzhou Medical University

基　　金：国家自然科学基金面上项目(81773701)。

摘　　要：目的探讨大动脉粥样硬化性非致残性缺血性脑血管病(NICE)患者认知功能减退的相关因素。方法纳入伴有颅内外动脉狭窄或闭塞的NICE患者84例和正常对照71例,收集入选者一般临床料及影像学资料,采用蒙特利尔认知评估量表(MoCA)评估认知功能。84例患者均行磁共振脑灌注检查。结果与正常对照组相比,NICE组年龄较大,吸烟率高,有高血压病史、糖尿病史和高糖化血红蛋白血症的患者所占百分率均高于正常对照组(P<0.05);NICE患者MoCA评分较正常对照组低(P<0.05);伴有脑低灌注的NICE患者认知功能在视觉执行、语言、延迟回忆方面降低较明显(P<0.05);低教育水平和脑低灌注是NICE患者认知功能减退的重要相关因素。结论大动脉粥样硬化性NICE患者常伴有认知功能减退,脑低灌注是认知功能减退的重要原因,而高教育水平是认知功能的保护性因素。视觉执行、语言、延迟回忆减退可能是NICE患者认知障碍的重要表现。Objective explore the risk factors of cognitive impairment in patients with large arteriosclerotic non-disabling ischemic cerebrovascular events(NICE).Methods A total of 84 NICE patients with stenosis or occlusion of intracranial and extracranial arteries(NICE group)and 71 normal control(normal control group)were included in this study.The general clinical data and imaging data were collected,and the cognitive function was assessed by the Montreal Cognitive Assessment Scale(MoCA).All the 84 NICE patients were examined by magnetic resonance(MR)cerebral perfusion imaging.Results Compared with the normal control group,the patients in the NICE group were older,with higher smoking rate and higher percentage of hypertension,diabetes,and hyperglycemia(P<0.05).MoCA score of the NICE group was lower than that of the normal control group(P<0.05).The cognitive impairment in the NICE patients with cerebral hypoperfusion was significantly reduced in visual execution,language,and delayed recall.Low level of education and low cerebral perfusion were important factors associated with cognitive impairment in NICE patients.Conclusions The NICE patients with large arteriosclerosis are often associated with cognitive impairment.Hypoperfusion is an important cause of cognitive impairment,and high education level is a protective factor of cognitive function.Impairment of visual execution,language and delayed recall might be important manifestations in NICE patients.

关 键 词：大动脉粥样硬化 非致残性缺血性脑血管病 认知功能减退 脑低灌注 

分 类 号：R743.3[医药卫生—神经病学与精神病学]