CAJ | 학술논문

目的评估脑白质疏松（leukoaraiosis，LA）的危险因素，以及对老年患者后期脑血管事件和认知功能障碍发病率的影响。方法连续入组北京安贞医院神经内科253例门诊患者，分为LA组和对照组，按照LA的严重程度，LA组分为轻度组、中度组、重度组。将简明精神状态量表（Mini-Mental State Examination，MMSE）和蒙特利尔认知评估量表（Montreal Cognitive Assessment，MoCA）（北京版）作为认知评估工具。分析各组患者一般临床资料和认知功能，随访观察并比较各组患者脑梗死、脑出血以及认知功能障碍的发病率。结果 LA组与对照组相比，患有高血压、糖尿病的比例显著升高，差异有显著性（P值分别为0.003和0.004）。中、重度LA组与对照组相比，认知障碍的患病率显著升高（P值分别为0.035和0.019）。随访1年，轻、中、重度LA组脑梗死的发病率均高于对照组，差异有显著性（P值分别为0.019、0.024和0.049）。四组间脑出血的发病率无显著差异。轻、中、重度LA组的新发认知障碍的发病率高于对照组，差异有显著性（P值分别为0.048、0.036和0.004）。结论老年LA患者认知障碍的患病率高于无白质疏松人群，且1年内新发认知障碍和缺血性卒中的发病率也高于无白质疏松人群。
목적평고뇌백질소송（leukoaraiosis，LA）적위험인소，이급대노년환자후기뇌혈관사건화인지공능장애발병솔적영향。방법련속입조북경안정의원신경내과253례문진환자，분위LA조화대조조，안조LA적엄중정도，LA조분위경도조、중도조、중도조。장간명정신상태량표（Mini-Mental State Examination，MMSE）화몽특리이인지평고량표（Montreal Cognitive Assessment，MoCA）（북경판）작위인지평고공구。분석각조환자일반림상자료화인지공능，수방관찰병비교각조환자뇌경사、뇌출혈이급인지공능장애적발병솔。결과 LA조여대조조상비，환유고혈압、당뇨병적비례현저승고，차이유현저성（P치분별위0.003화0.004）。중、중도LA조여대조조상비，인지장애적환병솔현저승고（P치분별위0.035화0.019）。수방1년，경、중、중도LA조뇌경사적발병솔균고우대조조，차이유현저성（P치분별위0.019、0.024화0.049）。사조간뇌출혈적발병솔무현저차이。경、중、중도LA조적신발인지장애적발병솔고우대조조，차이유현저성（P치분별위0.048、0.036화0.004）。결론노년LA환자인지장애적환병솔고우무백질소송인군，차1년내신발인지장애화결혈성졸중적발병솔야고우무백질소송인군。
Objective To determine whether the presence of leukoaraiosis (LA) is a risk factor for subsequent cerebral vascular disease and cognitive impairment. Methods We prospectively examined 253 consecutive outpatients at Department of Neurology of Beijing Anzhen Hospital. The patients were divided into two groups:patients with leukoaraiosis (LA group) and patients without leukoaraiosis (control group). According to the scores, the patients in LA group were divided into mild, moderate and severe groups. Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) (Beijing version) were used to assess the cognitive function. We analyzed clinical data. Patients were then followed up for the development of stroke and cognitive changes. Results In LA group, hypertension and diabetes were more common and there was signiifcant difference between LA and control group (P=0.003 and P=0.004, respectively). The prevalence of cognitive impairment in moderate and severe LA groups was much higher than those in control group (P=0.035 and P=0.019, respectively). The incidences of cerebral infarction in mild, moderate and severe LA group were much higher than those in control group (P=0.019, P=0.024 and P=0.049, respectively). The incidences of cognitive impairment in mild, moderate and severe were much higher than those in control group (P=0.048, P=0.036 and P=0.004, respectively). There was signiifcant difference between LA and control group for the development of cerebral infarction and cognitive impairment. Conclusion The incidence of cerebral infarction and cognitive impairment rose in senile patients with leukoaraiosis.