伴胆碱能通路白质病变的皮质下脑梗死患者的失语特点研究  

Study on the characteristics of aphasia in patients with subcortical cerebral infarction along with white matter lesions within the cholinergic pathway

作　　者：袁锡球[1] 黄龙龙[1] 罗根培[1] YUAN Xiqiu;HUANG Longlong;LUO Genpei(Neurology Department,Dongguan People′s Hospital in Guangdong Province,Dongguan523000,China)

机构地区：[1]广东省东莞市人民医院神经内科,广东东莞523000

出　　处：《中国现代医生》2021年第28期9-12,共4页China Modern Doctor

基　　金：广东省东莞市社会科技发展(一般)项目(2018507150011372)。

摘　　要：目的探讨伴胆碱能通路白质病变的皮质下脑梗死患者的失语特点。方法选取2018年6月至2020年6月我院神经内科住院患者中诊断为初次发病的皮层下梗死患者伴有明显言语障碍120例为研究对象,对所有入组患者行CHIPS量表检查,按评分结果分为无异常(A组,21例)、轻度异常(B组,63例)、明显异常(C组,36例)三组,对胆碱能通路的白质病变程度进行评分,对所有患者分别实施标准汉语失语量表(ABC)检查,Fazekas评分量表检查,对导致胆碱能通路损伤的白质病变ABC评分与Fazekas评分进行相关性分析。结果所有患者CHIPS总评分为(25.7±11.1)分,A组CHIPS评分为0分,B组CHIPS评分为(4.7±2.1)分,C组CHIPS评分为(23.2±6.8)分,三组比较,差异有统计学意义(P<0.01);A组ABC总评分为(654.3±58.5)分,B组ABC总评分为(526.1±34.7)分,C组ABC总评分为(327.6±23.5)分,三组比较,差异有统计学意义(P<0.01);患者Fazekas总评分为(5.4±2.8)分,A组Fazekas评分为0分,B组Fazekas评分为(2.2±0.3)分,C组Fazekas评分为(5.1±0.6)分,三组比较,差异有统计学意义(P<0.01)。结论皮质下脑梗死患者失语的程度可能与其白质病变中胆碱能通路的损害程度相关,CHIPS评分可评估损害程度。Objective To investigate the characteristics of aphasia in patients with subcortical cerebral infarction along with white matter lesions within the cholinergic pathway.Methods A total of 120 patients diagnosed with primary onset subcortical infarction along with prominent language impairment in the inpatients of the Neurology Department of our hospital from June 2018 to June 2020 were selected.The CHIPS scale examination was performed on all the enrolled patients.According to the scoring results,they were divided into three groups:no abnormality(group A,21 cases),mild abnormality(group B,63 cases),and obvious abnormality(group C,36 cases).The degrees of white matter lesions within the cholinergic pathway were scored,and all patients were tested with the standard Chinese aphasia scale(ABC)and the Fazekas score scale.The correlation analysis between the ABC scores and the Fazekas scores for white matter lesions causing cholinergic pathway damage was performed.Results The total CHIPS scores of all patients were(25.7±11.1)points;the CHIPS score of group A was 0 points,while the CHIPS score of group B was(4.7±2.1)and the CHIPS score of group C was(23.2±6.8)points.The differences among the three groups were statistically significant(P<0.01).The total ABC scores of group A were(654.3±58.5)points,while the total ABC scores of group B were(526.1±34.7)points and the total ABC scores of group C were(327.6±23.5)points.The differences among the three groups were also statistically significant(P<0.01).The total Fazekas scores of the patients were(5.4±2.8)points,with Fazekas scores of 0 points for group A,(2.2±0.3)points for group B,and(5.1±0.6)points for group C.The differences among the three groups were also statistically significant(P<0.01).Conclusion The degrees of aphasia in patients with subcortical cerebral infarction may be associated with the degrees of damage to the cholinergic pathway within the white matter lesions,and the CHIPS scores can assess the degree of damage.

关 键 词：脑梗死 缺血性脑血管病 脑白质病变 皮质下失语症 胆碱能通路 

分 类 号：R742[医药卫生—神经病学与精神病学]