缺血性脑卒中患者脑微出血对认知功能的影响  

Effect of cerebral microbleeds on cognition in patients with ischemic stroke

作　　者：朱方方[1] 许媛媛 寿广丽 冯敏 钱伟东[2] Zhu Fangfang;Xu Yuanyuan;Shou Guangli;Feng Min;Qian Weidong(Department of neurology,the second affiliated hospital of Bengbu Medical College,Bengbu,China,233040;Department of neurology,the first affiliated hospital of Bengbu Medical College,Bengbu,China,233040;不详)

机构地区：[1]蚌埠医学院第二附属医院神经内科,安徽蚌埠233040 [2]蚌埠医学院第一附属医院神经内科,安徽蚌埠233040 [3]不详

出　　处：《齐齐哈尔医学院学报》2022年第21期2026-2029,共4页Journal of Qiqihar Medical University

基　　金：蚌埠医学院自然科学重点项目(BYKY2019160ZD)。

摘　　要：目的探讨缺血性脑卒中患者脑叶、深部和幕下脑微出血(Cerebral microbleeds,CMBs)对认知功能的影响。方法回顾性分析2019年10月—2020年9月在本院住院治疗的70例缺血性脑卒中患者的临床资料,依据磁敏感加权成像(Susceptibility weighted imaging,SWI)分成脑微出血组(CMBs组)和非脑微出血组(N-CMBs组)两组,再按部位将CMBs组分为脑叶CMBs组、深部CMBs组和幕下CMBs组三组;用蒙特利尔认知评估量表(MoCA量表)评估所有患者认知功能。结果CMBs组与N-CMBs组在MoCA总分、视空间与执行、命名、注意、语言、延迟回忆、定向上差异均有统计学意义(P均<0.05)。脑叶CMBs VS.幕下CMBs、深部CMBs VS.幕下CMBs这两组在MoCA总分上差异均有统计学意义(P=0.038、P=0.001,P均<0.05);深部CMBs VS.幕下CMBs在视空间与执行功能、注意功能上差异均有统计学意义(P=0.035、P=0.008,P均<0.05);脑叶CMBs VS.幕下CMBs这两组在注意功能上差异有统计学意义(P=0.034<0.05)。结论脑微出血是认知功能下降的因素,不同位置的脑微出血对认知域的影响不同;深部微出血对视空间与执行、注意功能影响比较大,脑叶微出血对注意功能影响比较大。Objective To investigate the effects of cerebral lobe,deep and infratentorial cerebral microbleeds(CMBs)on cognitive function in patients with ischemic stroke.Methods The clinical data of 70 patients with ischemic stroke those were hospitalized in our hospital from October 2019 to September 2020 were retrospectively analyzed.According to susceptibility weighted imaging(SWI),the patients were divided into two groups:cerebral microbleeds group(CMBs group)and non-cerebral microbleeds group(N-CMBs group).According to the location,the CMBs group was divided into three groups:lobe CMBs group,deep CMBs group and infratentorial CMBs group.MoCA scale was used to evaluate the cognitive function of all patients.Results There were significant differences in MoCA total score,visual space and execution,naming,attention,language,delayed recall and orientation between CMBs group and N-CMBs group(P<0.05).There were significant differences in the total score of MoCA between the two groups of cerebral lobe CMBs and infratentorial CMBs,deep CMBs and infatentorial CMBs(P=0.038/P=0.001,P<0.05).There were significant differences in visual space and executive function/attention function between deep CMBs and infatentorial CMBs(P=0.035/P=0.008,P<0.05).There was significant difference in attention function between cerebral lobe CMBs and infratentorial CMBs(P=0.034<0.05).Conclusions Cerebral microbleeds is a factor of cognitive decline,and different locations of cerebral microbleeds have different effects on cognition.Deep CMBs has a great influence on visual space,execution and attention function,while cerebral lobe CMBs has a great influence on attention function.

关 键 词：缺血性脑卒中 脑微出血 MoCA评分 认知功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]