脑白质疏松与急性脑梗死患者认知功能的关系研究  

Relationship of Leukoaraiosis with Cognitive Function in Patients with Acute Brain Infarction

作　　者：王国瑜 汪洋 石华[2] 郭忠伟[1] 兰希发[1] WANG Guoyu;WANG Yang;SHI Hua;GUO Zhongwei;LAN Xifa(Department of Neurology,First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Clinical Laboratory,First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院神经内科,066000 [2]河北省秦皇岛市第一医院检验科,066000

出　　处：《实用心脑肺血管病杂志》2020年第5期23-26,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：背景近年急性脑梗死与脑白质疏松(LA)的关系是医学领域研究的热点。目的探讨LA与急性脑梗死患者认知功能的关系。方法选取2017年3月—2018年10月秦皇岛市第一医院神经内科收治的急性脑梗死患者200例,根据LA诊断标准分为LA组110例和无LA组90例;根据LA严重程度将110例急性脑梗死伴LA患者分为轻度38例、中度45例和重度27例,根据LA部位分为脑室周围型44例、深部白质型34例和混合型32例。比较LA组、无LA组患者一般资料及蒙特利尔认知评估量表(MoCA)总评分及各认知领域(包括视空间及执行功能、命名、注意力、语言、抽象、延迟回忆、定向力)评分;比较轻度、中度和重度LA患者MoCA总评分,脑室周围型、深部白质型和混合型LA患者MoCA总评分及各认知领域评分;急性脑梗死患者LA严重程度与MoCA总评分相关性分析采用Spearman秩相关分析。结果LA组患者年龄大于无LA组,MoCA总评分及各认知领域评分低于无LA组(P<0.05)。急性脑梗死伴重度LA患者MoCA总评分低于轻度、中度者,急性脑梗死伴中度LA患者MoCA总评分低于轻度者(P<0.05)。Spearman秩相关分析结果显示,急性脑梗死患者LA严重程度与MoCA总评分呈负相关(rs=-0.964,P<0.05)。急性脑梗死伴混合型LA患者视空间及执行功能评分及MoCA总评分低于脑室周围型、深部白质型LA者,急性脑梗死伴深部白质型LA患者视空间及执行功能评分及MoCA总评分低于脑室周围型LA者(P<0.05)。结论急性脑梗死伴LA患者多存在认知功能损伤,而其认知功能损伤程度与LA严重程度呈正相关,且混合型及深部白质型LA患者认知功能损伤较严重,尤其是视空间与执行功能损伤明显。Background In recent years,the relationship of leukoaraiosis(LA)with acute brain infarction has become the focus of the medical community.Objective To discuss the relationship of LA with cognitive function in patients with acute brain infarction.Methods 200 patients with acute brain infarction in Department of Neurology,First Hospital of Qinhuangdao from March 2017 to October 2018 were selected,and they were divided into LA group(n=110)and non-LA group(n=90)according to diagnostic criteria of LA;110 cases of acute brain infarction complicated with LA were divided into mild group(38 cases),moderate group(45 cases)and severe group(27 cases)according to the severity of LA,and divided into periventricular group(44 cases),deep white matter group(34 cases)and mixed group(32 cases)according to the location of LA.Clinical data,total MoCA score and subtype(including visual space and executive function,naming,attention,language,abstraction,delayed recall,orientation)scores were compared between LA group and non-LA group;total MoCA score was compared in mild group,moderate group and severe group,total MoCA and subtype scores were compared in periventricular group,deep white matter group and mixed group;correlation of the severity of LA with total MoCA score in acute brain infarction patients was analyse by Pearson correlation analysis.Results Age in LA group was elder than that in non-LA group,total MoCA score and subtype scores in LA group were lower than those in non-LA group(P<0.05).Total MoCA score in acute brain infarction complicated with severe LA patients was lowe than that in mild,moderate LA patients,total MoCA score in acute brain infarction complicated with moderate LA patients was lowe than that in mild LA patient(s P<0.05).Pearson correlation analysis showed that,the severity of LA in patients with acute brain infarction was negative correlated with total MoCA score(rs=-0.964,P<0.05).Visual space and executive function score and total MoCA score in mixed LA in patients with acute brain infarction were lower th

关 键 词：脑梗死 脑白质疏松 认知功能损伤 

分 类 号：R743.33[医药卫生—神经病学与精神病学]