CAJ | 학술논문

目的：了解急性缺血性卒中患者多维认知功能特点，为选择全面的、系统的评估工具提供参考根据。方法本研究为横断面研究，连续入组2013年8月～2014年4月第二炮兵总医院神经内科门诊和住院发病14 d内的急性缺血性卒中44例，选取年龄、性别、教育水平匹配的无缺血性卒中者44例为对照组。采用简易精神状态检查量表（Mini-Mental State Examination，MMSE）、中文版蒙特利尔认知评估量表（Montreal Congnitive Assessment，MoCA）、多维心理评估系统对急性缺血性卒中组和对照组进行认知评估。结果急性缺血性卒中组与对照组在下列测验中差异无显著性：选择反应时测验（27.16±5.02 vs 28.34±5.66；P=0.347）、瑞文推理测验（12.13±5.81 vs 14.91±7.03；P=0.643）、数字序列推理测验（8.68±5.23 vs 11.43±4.76；P=0.287）、词语记忆能力测验（50.98±19.97 vs 56.78±15.89；P=0.316）、言语工作记忆测验（正向）（6.88±1.91 vs 7.23±1.62；P=0.178）、言语工作记忆（反向）（4.31±1.76 vs 5.23±2.13；P=0.922）、语义流畅性测验（11.37±2.65 vs 13.27±1.65；P=0.142）；急性缺血性卒中组在简单计算测验（28.95±15.86 vs 41.26±9.32；P=0.007）、数量大小比较测验（65.75±19.22 vs 79.43±8.62；P=0.008）、空间工作记忆测验（69.63±28.97 vs 83.16±7.23；P=0.004）、图片记忆测验（58.39±18.13 vs 68.64±9.13；P=0.009）、词语辨析测验（20.16±8.22 vs 29.43±5.27；P=0.008）、颜色判断Stroop测验（执行功能）（65.37±22.79 vs 70.83±4.16；P=0.000）上显著低于对照组。结论多维认知功能测查表明急性缺血性卒中患者仅存在局部认知功能受损，能够更详细地反映患者的认知状况。
목적：료해급성결혈성졸중환자다유인지공능특점，위선택전면적、계통적평고공구제공삼고근거。방법본연구위횡단면연구，련속입조2013년8월～2014년4월제이포병총의원신경내과문진화주원발병14 d내적급성결혈성졸중44례，선취년령、성별、교육수평필배적무결혈성졸중자44례위대조조。채용간역정신상태검사량표（Mini-Mental State Examination，MMSE）、중문판몽특리이인지평고량표（Montreal Congnitive Assessment，MoCA）、다유심리평고계통대급성결혈성졸중조화대조조진행인지평고。결과급성결혈성졸중조여대조조재하렬측험중차이무현저성：선택반응시측험（27.16±5.02 vs 28.34±5.66；P=0.347）、서문추리측험（12.13±5.81 vs 14.91±7.03；P=0.643）、수자서렬추리측험（8.68±5.23 vs 11.43±4.76；P=0.287）、사어기억능력측험（50.98±19.97 vs 56.78±15.89；P=0.316）、언어공작기억측험（정향）（6.88±1.91 vs 7.23±1.62；P=0.178）、언어공작기억（반향）（4.31±1.76 vs 5.23±2.13；P=0.922）、어의류창성측험（11.37±2.65 vs 13.27±1.65；P=0.142）；급성결혈성졸중조재간단계산측험（28.95±15.86 vs 41.26±9.32；P=0.007）、수량대소비교측험（65.75±19.22 vs 79.43±8.62；P=0.008）、공간공작기억측험（69.63±28.97 vs 83.16±7.23；P=0.004）、도편기억측험（58.39±18.13 vs 68.64±9.13；P=0.009）、사어변석측험（20.16±8.22 vs 29.43±5.27；P=0.008）、안색판단Stroop측험（집행공능）（65.37±22.79 vs 70.83±4.16；P=0.000）상현저저우대조조。결론다유인지공능측사표명급성결혈성졸중환자부존재국부인지공능수손，능구경상세지반영환자적인지상황。
Objective To study the characteristics of multi-dimensional cognitive function of acute ischemic stroke patient, which can be used as a reference for comprehensive assessment. Methods Eighty eight consecutive patients at Department of Neurology of the Second Artillery General Hospital were prospectively enrolled into this study. The patients were divided into two groups:patients with acute ischemic stroke (44) and control group (44) whose age, gender, education level were well matched. Mini-Mental State Examination (MMSE), Montreal Congnitive Assessmen (MoCA) and Multi-dimensional Cognitive Function test were used to assess the cognitive function. Results No significant differences are revealed between the acute ischemic stroke group and the reference group in Choice Reaction Time Test (27.16±5.02 vs 28.34±5.66, P=0.347), Raven Standard Reasoning Test (12.13±5.81 vs 14.91±7.03, P=0.643), Number Sequence Reasoning Test (8.68±5.23 vs 11.43±4.76, P=0.287), Word Memory Test (50.98±19.97 vs 56.78±15.89, P=0.316), Word Working Memory Test (6.88±1.91 vs 7.23±1.62, P=0.178), Verbal Fluency Test (11.37±2.65 vs 13.27±1.65, P=0.142). The score between two groups in terms of Simple Computation Test (28.95±15.86 vs 41.26±9.32, P=0.007), Number Comparison Test (65.75±19.22 vs 79.43±8.62, <br> P=0.008), Spatial Working Memory Test (69.63±28.97 vs 83.16±7.23, P=0.004), Picture Memory Test (58.39±18.13 vs 68.64±9.13, P=0.009), Word Discriminating Test (20.16±8.22 vs 29.43±5.27, P=0.008), Stroop Test (65.37±22.79 vs 70.83±4.16, P=0.000) demonstrated a statistical signiifcance. Conclusion The multi-dimensional cognitive function assessment system relfects that there is local impaired cognitive function in individual cognitive level. It could reflect the cognitive condition of patients in detail.