中华行为医学与脑科学杂志
中華行為醫學與腦科學雜誌
중화행위의학여뇌과학잡지
CHINESE JOURNAL OF BEHAVIORAL MEDICINE AND BRAIN SCIENCE
2009年
5期
418-420
,共3页
王久武%孙月吉%庞鑫鑫%林媛%于亮%李倩%婉思莹%周世煜%郇明明
王久武%孫月吉%龐鑫鑫%林媛%于亮%李倩%婉思瑩%週世煜%郇明明
왕구무%손월길%방흠흠%림원%우량%리천%완사형%주세욱%순명명
缺血性脑卒中%基底节%认知功能
缺血性腦卒中%基底節%認知功能
결혈성뇌졸중%기저절%인지공능
Ischemic Stroke%Basal ganglia%Cognition
目的 探讨基底节缺血性卒中导致的认知功能损害特点.方法 基底节缺血性卒中住院患者46例为观察组,所有病例均符1995年10月中华医学会第四届脑血管病学术研讨会通过的脑卒中诊断标准;对照组为性别、年龄和教育程度与观察组相匹配的健康人46例.认知评价采用一般问卷、韦氏成人智力量表的词汇及数字符号测试、韦氏记忆量表、工作记忆课题及威斯康星卡片等,共收集了20项认知功能相关指标.结果 观察组的连线作业A[(54.04±5.66)分]、执行完成分类数[(3.56±0.12)分]、执行错误应答数[(16.17±0.58)分]、执行非持续性错误数[(10.17±0.58)分]的得分显著高于对照组(t=4.67,5.03,9.45,9.5;P<0.01),而词汇测试{(54.21±2.73)分]、经历[(4.52±0.12)分]、定向[(4.65±0.11)分]、视觉再认[(8.34±0.62)分]、图片回忆[(8.13±0.43)分]、视觉再生[(6.957±0.48)分]、触觉记忆[(61.06±9.09)分]、联想学习[(7.39±0.51)分]、顺背[(6.17±0.31)分]、倒背[(3.13±0.14)分]和连线作业B[(122.39±8.28)分]的得分显著低于对照组(P<0.01);左右侧基底节缺血性卒中的认知指标显示:在数字符号、定向、执行正确应答数、错误应答数、持续性错误、非持续性错误数6个项目上的差异具有统计学意义(P<0.05或0.01);卒中体积与认知功能相关分析:两侧基底节缺血性卒中体积与完成分类数呈正相关(r>0,P<0.05),与顺背与倒背呈负相关(r=-0.857,-0.811;P=0.014,0.027);左侧基底节缺血性卒中体积与词汇测试、经历、视觉再认呈负相关(r=-0.764,-0.907,-0.747;P=0.027,0.002,0.033);右侧基底节缺血性卒中体积与词汇测试、数字符号、视觉再生、执行完成分类数呈负相关(r=-0.747,-0.770,-0.798;P=0.033,0.026,0.011).结论 基底节缺血性卒中可以引起言语智能、执行功能及记忆等认知功能改变,两侧基底节在操作智能、长时记忆及执行功能方面发挥作用不同,基底节卒中体积越大,认知功能损害越明显.
目的 探討基底節缺血性卒中導緻的認知功能損害特點.方法 基底節缺血性卒中住院患者46例為觀察組,所有病例均符1995年10月中華醫學會第四屆腦血管病學術研討會通過的腦卒中診斷標準;對照組為性彆、年齡和教育程度與觀察組相匹配的健康人46例.認知評價採用一般問捲、韋氏成人智力量錶的詞彙及數字符號測試、韋氏記憶量錶、工作記憶課題及威斯康星卡片等,共收集瞭20項認知功能相關指標.結果 觀察組的連線作業A[(54.04±5.66)分]、執行完成分類數[(3.56±0.12)分]、執行錯誤應答數[(16.17±0.58)分]、執行非持續性錯誤數[(10.17±0.58)分]的得分顯著高于對照組(t=4.67,5.03,9.45,9.5;P<0.01),而詞彙測試{(54.21±2.73)分]、經歷[(4.52±0.12)分]、定嚮[(4.65±0.11)分]、視覺再認[(8.34±0.62)分]、圖片迴憶[(8.13±0.43)分]、視覺再生[(6.957±0.48)分]、觸覺記憶[(61.06±9.09)分]、聯想學習[(7.39±0.51)分]、順揹[(6.17±0.31)分]、倒揹[(3.13±0.14)分]和連線作業B[(122.39±8.28)分]的得分顯著低于對照組(P<0.01);左右側基底節缺血性卒中的認知指標顯示:在數字符號、定嚮、執行正確應答數、錯誤應答數、持續性錯誤、非持續性錯誤數6箇項目上的差異具有統計學意義(P<0.05或0.01);卒中體積與認知功能相關分析:兩側基底節缺血性卒中體積與完成分類數呈正相關(r>0,P<0.05),與順揹與倒揹呈負相關(r=-0.857,-0.811;P=0.014,0.027);左側基底節缺血性卒中體積與詞彙測試、經歷、視覺再認呈負相關(r=-0.764,-0.907,-0.747;P=0.027,0.002,0.033);右側基底節缺血性卒中體積與詞彙測試、數字符號、視覺再生、執行完成分類數呈負相關(r=-0.747,-0.770,-0.798;P=0.033,0.026,0.011).結論 基底節缺血性卒中可以引起言語智能、執行功能及記憶等認知功能改變,兩側基底節在操作智能、長時記憶及執行功能方麵髮揮作用不同,基底節卒中體積越大,認知功能損害越明顯.
목적 탐토기저절결혈성졸중도치적인지공능손해특점.방법 기저절결혈성졸중주원환자46례위관찰조,소유병례균부1995년10월중화의학회제사계뇌혈관병학술연토회통과적뇌졸중진단표준;대조조위성별、년령화교육정도여관찰조상필배적건강인46례.인지평개채용일반문권、위씨성인지역량표적사회급수자부호측시、위씨기억량표、공작기억과제급위사강성잡편등,공수집료20항인지공능상관지표.결과 관찰조적련선작업A[(54.04±5.66)분]、집행완성분류수[(3.56±0.12)분]、집행착오응답수[(16.17±0.58)분]、집행비지속성착오수[(10.17±0.58)분]적득분현저고우대조조(t=4.67,5.03,9.45,9.5;P<0.01),이사회측시{(54.21±2.73)분]、경력[(4.52±0.12)분]、정향[(4.65±0.11)분]、시각재인[(8.34±0.62)분]、도편회억[(8.13±0.43)분]、시각재생[(6.957±0.48)분]、촉각기억[(61.06±9.09)분]、련상학습[(7.39±0.51)분]、순배[(6.17±0.31)분]、도배[(3.13±0.14)분]화련선작업B[(122.39±8.28)분]적득분현저저우대조조(P<0.01);좌우측기저절결혈성졸중적인지지표현시:재수자부호、정향、집행정학응답수、착오응답수、지속성착오、비지속성착오수6개항목상적차이구유통계학의의(P<0.05혹0.01);졸중체적여인지공능상관분석:량측기저절결혈성졸중체적여완성분류수정정상관(r>0,P<0.05),여순배여도배정부상관(r=-0.857,-0.811;P=0.014,0.027);좌측기저절결혈성졸중체적여사회측시、경력、시각재인정부상관(r=-0.764,-0.907,-0.747;P=0.027,0.002,0.033);우측기저절결혈성졸중체적여사회측시、수자부호、시각재생、집행완성분류수정부상관(r=-0.747,-0.770,-0.798;P=0.033,0.026,0.011).결론 기저절결혈성졸중가이인기언어지능、집행공능급기억등인지공능개변,량측기저절재조작지능、장시기억급집행공능방면발휘작용불동,기저절졸중체적월대,인지공능손해월명현.
Objective To find the correlation factors of cognitive disorder after ischemic basal ganglia's stroke. Methods 46 cases of ischemic basal ganglia's stroked patients by MRI. And 46 cases health control were tested by Wechsler Adult Intelligence Scale (WAIS),Wechsler Memory Scale (WMS),Trail Making Test A and B,Wisconsin Card Sorting Test (WCST).t test,chi-square,two independent samples and spearmancorrelation were used to analyze the data. Results 1)Group of thalamic stroke compare with health control for recognition index,there were significant different between the two groups,there were higher score in the stroke group at trail making test A (54.04±5.66),Executive complete number of categories (Cc)(3.56±0.12),Executive error responsive number (Re)(16.17±0.58),non Executive persist error number.Contrary at vocabulary(54.21±2.73),Undergoing(4.52±0.12),Rotation,Visual recognition(8.34±0.62),Figure recognition(8.13±0.43),Visual recall(6.957±0.48),Association thinking(7.39±0.51),the touch memory(61.06±9.09),Recite(6.17±0.31) and Inverse recite(3.13±0.14),the trail making test B(122.39±8.28)(P<0.01). 2) Compare of cognition after left and right side basal ganglia's stroke:there were six items of cognition have significant difference,those were Digit symbol,Orientation,Executive complete number of categories (Cc),Executive error responsive number (Re),non Executive persist error number (nRpe),Executive persist number (Rp) (P<0.01). 3) Correlative analysis:direct and inverted recite negative correlated with stroke volume(r=-0.857,-0.811;P=0.014,0.027),Completed number of categories have positive correlation with stroke volume (r=0.822,P=0.023). The left side stroke correlated with Vocabulary Test,Experience,Visual recognition(r=-0.764,-0.907,-0.747;P=0.027,0.002,0.033); the right stroke correlated with Vocabulary Test,Symbolic figure,Visual renewable,negative correlation with Executive completed number of categories(r=-0.747,-0.770,-0.798;P=0.033,0.026,0.011).Conclusion Basal ganglia's stroke can cause various cognition disorders,especially in vocabulary intelligence,executive function and memory. The different side of basal ganglia's stroke may have different effect on procedure intelligence,long-term memory and executive function. Stroke volume related with cognition.
