临床医学
臨床醫學
림상의학
CLINICAL MEDICINE
2014年
8期
15-17
,共3页
牛智领%牛好敏%刘远洪%葛晓航%郝静%闫斌
牛智領%牛好敏%劉遠洪%葛曉航%郝靜%閆斌
우지령%우호민%류원홍%갈효항%학정%염빈
缺血性脑小血管病%轻度认知障碍%蒙特利尔认知功能评估量表
缺血性腦小血管病%輕度認知障礙%矇特利爾認知功能評估量錶
결혈성뇌소혈관병%경도인지장애%몽특리이인지공능평고량표
Ischemic cerebral small vessel disease%Mild cognitive impairment%Montreal cognitive assessment scale
目的：探讨缺血性脑小血管病所导致轻度认知障碍患者的危险因素，为早期诊断和早期干预提供依据。方法应用蒙特利尔认知评估量表（ Montreal Cngnitive Assessment）筛查轻度认知障碍（ MCI），收集相关危险因素，并进行神经心理学测试。根据MRI表现分为脑白质疏松（ LA ）、腔隙性脑梗死（ LI ）和 LA与 LI 并存（ LA+LI ）3种类型。结果共纳入150例，其中MCI组70例，非MCI组80例，单因素分析显示，MCI组年龄、性别构成比与非MCI组比较差异无统计学意义，但受教育年限显著短于非MCI组[（9.06±4.46）岁vs（11.48±3.51）岁；t=-5.116，P﹤0.001]，而高血压病（71.4% vs 45.0%；χ2=8.325，P=0.004）、糖尿病（55.7% vs 40.00%；χ2=4.801，P=0.028）、高脂血症（48.5%vs 23.7%；χ2=9.552，P=0.002）、颈动脉硬化（42.8% vs 18.7%；χ2=6.871，P=0.010）、吸烟（34.3% vs 13.8%；χ2=6.581，P=0.011）构成比及总胆固醇[（5.26±1.26）mmol/L vs（4.56±1.23）mmol/L；t =3.326，P =0.001]、尿酸[（351.81±83.21）mmol/L vs（323.03±80.43）mmol/L；t=2.102，P=0.0371]水平显著高于非MCI组。结论高血压病、糖尿病、高脂血症、颈动脉硬化、吸烟及教育水平较低是缺血性脑小血管病患者MCI的独立危险因素。
目的：探討缺血性腦小血管病所導緻輕度認知障礙患者的危險因素，為早期診斷和早期榦預提供依據。方法應用矇特利爾認知評估量錶（ Montreal Cngnitive Assessment）篩查輕度認知障礙（ MCI），收集相關危險因素，併進行神經心理學測試。根據MRI錶現分為腦白質疏鬆（ LA ）、腔隙性腦梗死（ LI ）和 LA與 LI 併存（ LA+LI ）3種類型。結果共納入150例，其中MCI組70例，非MCI組80例，單因素分析顯示，MCI組年齡、性彆構成比與非MCI組比較差異無統計學意義，但受教育年限顯著短于非MCI組[（9.06±4.46）歲vs（11.48±3.51）歲；t=-5.116，P﹤0.001]，而高血壓病（71.4% vs 45.0%；χ2=8.325，P=0.004）、糖尿病（55.7% vs 40.00%；χ2=4.801，P=0.028）、高脂血癥（48.5%vs 23.7%；χ2=9.552，P=0.002）、頸動脈硬化（42.8% vs 18.7%；χ2=6.871，P=0.010）、吸煙（34.3% vs 13.8%；χ2=6.581，P=0.011）構成比及總膽固醇[（5.26±1.26）mmol/L vs（4.56±1.23）mmol/L；t =3.326，P =0.001]、尿痠[（351.81±83.21）mmol/L vs（323.03±80.43）mmol/L；t=2.102，P=0.0371]水平顯著高于非MCI組。結論高血壓病、糖尿病、高脂血癥、頸動脈硬化、吸煙及教育水平較低是缺血性腦小血管病患者MCI的獨立危險因素。
목적：탐토결혈성뇌소혈관병소도치경도인지장애환자적위험인소，위조기진단화조기간예제공의거。방법응용몽특리이인지평고량표（ Montreal Cngnitive Assessment）사사경도인지장애（ MCI），수집상관위험인소，병진행신경심이학측시。근거MRI표현분위뇌백질소송（ LA ）、강극성뇌경사（ LI ）화 LA여 LI 병존（ LA+LI ）3충류형。결과공납입150례，기중MCI조70례，비MCI조80례，단인소분석현시，MCI조년령、성별구성비여비MCI조비교차이무통계학의의，단수교육년한현저단우비MCI조[（9.06±4.46）세vs（11.48±3.51）세；t=-5.116，P﹤0.001]，이고혈압병（71.4% vs 45.0%；χ2=8.325，P=0.004）、당뇨병（55.7% vs 40.00%；χ2=4.801，P=0.028）、고지혈증（48.5%vs 23.7%；χ2=9.552，P=0.002）、경동맥경화（42.8% vs 18.7%；χ2=6.871，P=0.010）、흡연（34.3% vs 13.8%；χ2=6.581，P=0.011）구성비급총담고순[（5.26±1.26）mmol/L vs（4.56±1.23）mmol/L；t =3.326，P =0.001]、뇨산[（351.81±83.21）mmol/L vs（323.03±80.43）mmol/L；t=2.102，P=0.0371]수평현저고우비MCI조。결론고혈압병、당뇨병、고지혈증、경동맥경화、흡연급교육수평교저시결혈성뇌소혈관병환자MCI적독립위험인소。
Objective To investigate the risk factors of mild cognitive impairment( MCI)in patients with ischemic cerebral small vessel disease( SVD)and provide basis for early diagnosis and intervention. Methods Cognitive Assessment Scale( Mo-CA)was used to screen MCI. The related risk factors were collected,and other neuropsychological tests were conducted. Accord-ing to the MRI manifestation, the patients were divided into leukoaraiosis( LA ),lacunar infarction( LI ),and LA + LI. Results A total of 150 patients withs SVD were enrolled(70 cases in MCI group,80 cases in non-MCI group). Univariate anal-ysis showed that there was no significant difference in ages or sex constituent ratio between the MCI and non-MCI group,but the years of education in MCI group was shorter than that in non-MCI group[(9. 06 ± 4. 46)years vs(11. 48 ± 3. 51)years;t=-5. 116,P﹤0. 001],and the constituent ratio of hypertension(71. 4% vs 45. 0%;χ2 =8. 325,P=0. 004),diabetes(55. 7%vs 40. 0%;χ2 =4. 801,P =0. 028 ),hyperlipidemia( 48. 5% vs 23. 7%;χ2 =9. 552,P =0. 002 ),carotid atherosclerosis (42. 8% vs 18. 7%,χ2 =6. 871,P=0. 010),smoking(34. 3% vs 13. 8%;χ2 =6. 581,P=0. 011)and the levels of total cho-lesterol[(5. 26 ± 1. 26)mmol/L vs(4. 56 ± 1. 23)mmol/L;t=3. 326,P=0. 001],uric acid[(351. 81 ± 83. 21)mmol/L vs (323. 03 ± 80. 43)mmol/L;t =2. 102,P =0. 0371]in MCI group were significant higher than those in non-MCI group. Conclusion Ischemic cerebral sypertension,diabetes,hyperlipidemia,carotid atherosclerosis,smoking,and the low level of edu-cation are the independent risk factors for MCI in patients with SVD.
