CAJ | 학술논문

目的：探讨无症状性脑梗死(silent cerebral infarction, SCI)合并抑郁患者选择注意功能损害的特点，抑郁与选择注意及与认知功能障碍的关系。方法选择SCI患者(SCI组)、无SCI的抑郁症患者(无SCI抑郁组)和正常人(对照组)各82例，采用汉密尔顿抑郁(Hamilton Depression Rating Scale, HAMD)量表、蒙特利尔认知评估(Montreal cognitive assessment, MoCA)和Stroop色词测验(Stroop color-word test, CWT)进行评价，SCI患者再根据HAMD得分分为抑郁组和非抑郁组。结果 SCI组MoCA评分为(23.11±5.41)，较对照组(28.70±2.18)降低，其中抑郁组为(20.31±5.44)，降低更为明显(均P<0.01)。与对照组相比，SCI组的任务A、B、C和Stroop干扰效应(Stroop in-terference effects, SIE)耗时延长(P<0.01)，其中抑郁组为(33.25±14.10)、(42.45±15.18)、(104.68±25.08)、(62.24±21.53)秒；SCI组的任务B、C和SIE错误数增多(P<0.05)，抑郁组为(3.59±2.14)、(15.67±7.20)、(12.08±6.46)，抑郁组变化最为明显。其MoCA评分与SIE耗时和错误数呈负相关(r=-0.429, r=-0.500,均P<0.01)。梗死灶位置与HAMD评分和SIE错误数有一定关系：两者得分左侧梗死组高于右侧梗死组，皮质梗死组SIE得分高于皮质下梗死组，而HAMD评分相反。结论 SCI合并抑郁的患者选择注意功能有明显损害，且与认知功能水平具有良好的相关性。
목적：탐토무증상성뇌경사(silent cerebral infarction, SCI)합병억욱환자선택주의공능손해적특점，억욱여선택주의급여인지공능장애적관계。방법선택SCI환자(SCI조)、무SCI적억욱증환자(무SCI억욱조)화정상인(대조조)각82례，채용한밀이돈억욱(Hamilton Depression Rating Scale, HAMD)량표、몽특리이인지평고(Montreal cognitive assessment, MoCA)화Stroop색사측험(Stroop color-word test, CWT)진행평개，SCI환자재근거HAMD득분분위억욱조화비억욱조。결과 SCI조MoCA평분위(23.11±5.41)，교대조조(28.70±2.18)강저，기중억욱조위(20.31±5.44)，강저경위명현(균P<0.01)。여대조조상비，SCI조적임무A、B、C화Stroop간우효응(Stroop in-terference effects, SIE)모시연장(P<0.01)，기중억욱조위(33.25±14.10)、(42.45±15.18)、(104.68±25.08)、(62.24±21.53)초；SCI조적임무B、C화SIE착오수증다(P<0.05)，억욱조위(3.59±2.14)、(15.67±7.20)、(12.08±6.46)，억욱조변화최위명현。기MoCA평분여SIE모시화착오수정부상관(r=-0.429, r=-0.500,균P<0.01)。경사조위치여HAMD평분화SIE착오수유일정관계：량자득분좌측경사조고우우측경사조，피질경사조SIE득분고우피질하경사조，이HAMD평분상반。결론 SCI합병억욱적환자선택주의공능유명현손해，차여인지공능수평구유량호적상관성。
Objective To explore the characteristics of selective attention function in patients with silent cerebral in-farction (SCI) and depression, the relationship between depression, selective attention and cognitive dysfunction. Methods Eighty-two patients with SCI and 82 normal subjects were selected and evaluated by using Hamilton Depression Rating Scale (HAMD), Montreal cognitive assessment (MoCA) and Stroop color-word test (CWT). Patients with SCI were further classified into depression subgroup and no-depression subgroup based on the score of HAMD. Results The score of MoCA was lower in SCI group (23.11 ± 5.41) and was much lower in depression subgroup (20.31 ± 5.44) compared with control group (28.70 ± 2.18) (all P<0.01). Compared with control group, the reaction times of card A, B, C and Stroop interference effects (SIE) were prolonged in SCI group. The reaction time of card A, B, C and SIE were (33.25±14.10);(42.45±15.18);(104.68 ± 25.08) and (62.24 ± 21.53) in depression subgroup, respectively. The error counts of card B, C and SIE were in-creased (P<0.05) in SCI group. The error counts of card B,C and SIE were (3.59±2.14), (15.67±7.20) and (12.08±6.46) in depression subgroup, respectively. The scores of MoCA were negatively correlated with the reaction time and error counts of SIE (r=-0.429,r=-0.500,all P<0.01).The location of infarction was correlated with the score of HAMD and error counts of SIE to some degree: both of the scores were higher in patients with left infarction compared with right infarction and were higher in patients with cortex infarction compared with subcortex infarction. Conclusion The present study revealed that patients with SCI and depression have selective attention deficit which is closely correlated with the level of cognitive function.