基于铃木分期的成人烟雾病认知功能初步研究  

Cognitive function of adult patients with Moyamoya disease based on cerebralangiography:A preliminary study

作　　者：马丁[1,2] 石志勇 张东 Ma Ding;Shi Zhiyong;Zhang Dong(Department of Radiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Beijing Neurosurgical Institute,Capital Medical University,Beijing 100070,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院放射科,100070 [2]首都医科大学,北京市神经外科研究所,100070 [3]首都医科大学附属北京天坛医院神经外科,100070

出　　处：《中华神经外科杂志》2020年第7期671-676,共6页Chinese Journal of Neurosurgery

基　　金：国家科技支撑计划(2015BAI12B04)。

摘　　要：目的:初步研究成人烟雾病患者的认知功能情况。方法:前瞻性连续纳入2018年12月至2019年4月首都医科大学附属北京天坛医院神经外科收治的成人烟雾病患者36例(烟雾病组),以及同期体检的性别、年龄及受教育程度相匹配的22名健康者为健康对照组。对两组进行简易韦氏成人智力量表测试、前瞻性记忆(PM)测试(中文版剑桥PM测试量表)、神经心理状态测试(RBANS)、Stroop测试、连线测试A(TMT-A)测试、威斯康星卡片分类测试(WCST)及视听觉注意力持续操作测试(简称CPT测验)。所测项目≥3项异常时,诊断为认知功能障碍。根据左、右侧大脑半球的铃木分期,将烟雾病患者分为右侧大脑半球的铃木分期>左侧组(简称右侧>左侧组)9例和左侧大脑半球的铃木分期≥右侧组(简称左侧≥右侧组)27例,比较两组患者的认知功能情况。结果:36例患者中,10例(28%)存在认知功能障碍。与健康对照组比较,烟雾病组存在智商、PM、语言流畅性、注意力、回顾性记忆(延迟记忆)及执行功能等广泛的认知功能低下(均P<0.05)。对智商进行变量控制后,与健康对照组比较,烟雾病组基于时间的PM(TBPM)[分别为(12.4±2.8)分、(9.4±3.9)分]、PM总分[分别为(26.5±3.9)分、(21.4±6.5)分]及RBANS测试中的注意力得分[分别为(108.6±9.2)分、(95.6±15.0)分]均较低,差异均有统计学意义(均P<0.05);RBANS测试中的回顾性记忆差异无统计学意义[分别为(90.7±9.9)分、(82.5±14.4)分,P>0.05]。与右侧>左侧组比较,左侧≥右侧组的韦氏成人智力量表中的木块量表评分低,Stroop测试中单字识别和双色识别耗时长,CPT测试中的视觉遗漏数多、视觉反应时间长,TMT-A中连线时间长、判断正误正确的总数低,差异均有统计学意义(均P<0.05)。结论:成人烟雾病患者存在广泛的认知功能下降,其中记忆功能和注意力受损明显;左侧大脑半球受损更易引发认知障碍�Objective To conduct a preliminary study of the cognitive function of adult patients with Moyamoya disease(MMD).Methods We prospectively enrolled 36 adult MMD patients admitted to Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University from December 2018 to April 2019 and 22 healthy controls(HC)matched with gender,age and education level who underwent health examination during the same period.Both groups underwent the assessment of cognitive function based on the examinations including intelligence quotient(IQ),prospective memory(PM),Repeatable Battery for Assessment of Neuropsychological Status(RBANS),Stroop test,Trail Making Test A(TMT-A),Wisconsin Card Sorting Test(WCST)and Continuous Performance Test(CPT).When abnormal performance in 3 or more neuropsychological tests was observed,cognitive impairment was considered.According to the comparison of Suzuki stage(SS)in the left and right cerebral hemispheres,adult patients with MMD were divided into the subgroup with SS in the right side>SS in the left side(9 cases)and the subgroup with SS in left side≥SS in the right side(27 cases),and the cognitive function was compared between the 2 subgroups.Results Out of 36 cases,10(28%)was diagnosed with cognitive impairment.Compared with HC,adult MMD patients had a comprehensive cognitive function impairment,including IQ,PM,verbal function(VF),attention,retrospective memory(RM)and executive function(EF)(all P<0.05).Through covariance analysis of IQ,significant differences were revealed in scores of time-based prospective memory(TBPM),PM and attention between HC and adult MMD patients(all P<0.05).Specifically,the cognitive scores of TBPM were 12.4±2.8 and 9.4±3.9,those of PM were 26.5±3.9 and 21.4±6.5 those of RBANS(in attention dimension)were 108.6±9.2 and 95.6±15.0 in HC and adult MMD groups respectively.In contrast,scores of retrospective memory(RM),called as delayed memory in the RBANS test,of MMD and HC groups were 90.7±9.9 and 82.5±14.4 respectively,which had no significant difference

关 键 词：脑底异常血管网病 认知障碍 成年人 铃木分期 

分 类 号：R651.12[医药卫生—外科学]