CAJ | 학술논문

目的探讨脑微出血(cerebral microbleeds,CMBs)与认知功能变化之间的关系及CMBs引起认知功能障碍的可能机制.方法以头颅MR磁敏感加权成像(susceptibility weighted imagine,SWI)技术见脑微出血灶者为病例组共68例,选取头颅SWI序列未见微出血灶患者68例符合入选标准者作为对照组,两组同时运用蒙特利尔认知评估量表(MoCA)、画钟试验(CDT)进行评估.结果 CMBs组的CDT分值[(2.00±0.88)分]明显低于对照组[(3.76±0.53)分],且差异有统计学意义(t=-3.27,P=0.00).CMBs组的MoCA总分及执行功能、命名、计算、语言、概括抽象、记忆评分均明显低于对照组,且差异有统计学意义(t=-5.48,P=0.00;t=-4.36,P=0.00;t=-2.35,P=0.01;t=-2.49,P=0.02;t=-4.09,P=0.00;t=-4.63,P=0.00);CMBs轻度、中度、重度组CDT分值、MoCA总分、执行功能、语言、抽象概括、记忆评分与对照组比较差异均有统计学意义(P＜0.05),CMBs轻度组、中度组、重度组语言、计算及执行功能(CDT反映)得分组间差异有统计学意义(P＜0.05).CMBs数目与总分、执行功能、语言、抽象概括呈负相关(r=-0.675,P=0.000; r=-0.689,P=0.000;r=-0.536,P=0.000;r=-0.636,P=0.000).结论 CMBs是否存在及数目多少和患者认知功能损害密切相关,CMBs数目越多,认知功能损害越明显.
목적 탐토뇌미출혈(cerebral microbleeds,CMBs)여인지공능변화지간적관계급CMBs인기인지공능장애적가능궤제.방법 이두로MR자민감가권성상(susceptibility weighted imagine,SWI)기술견뇌미출혈조자위병례조공68례,선취두로SWI서렬미견미출혈조환자68례부합입선표준자작위대조조,량조동시운용몽특리이인지평고량표(MoCA)、화종시험(CDT)진행평고.결과 CMBs조적CDT분치[(2.00±0.88)분]명현저우대조조[(3.76±0.53)분],차차이유통계학의의(t=-3.27,P=0.00).CMBs조적MoCA총분급집행공능、명명、계산、어언、개괄추상、기억평분균명현저우대조조,차차이유통계학의의(t=-5.48,P=0.00;t=-4.36,P=0.00;t=-2.35,P=0.01;t=-2.49,P=0.02;t=-4.09,P=0.00;t=-4.63,P=0.00);CMBs경도、중도、중도조CDT분치、MoCA총분、집행공능、어언、추상개괄、기억평분여대조조비교차이균유통계학의의(P＜0.05),CMBs경도조、중도조、중도조어언、계산급집행공능(CDT반영)득분조간차이유통계학의의(P＜0.05).CMBs수목여총분、집행공능、어언、추상개괄정부상관(r=-0.675,P=0.000; r=-0.689,P=0.000;r=-0.536,P=0.000;r=-0.636,P=0.000).결론 CMBs시부존재급수목다소화환자인지공능손해밀절상관,CMBs수목월다,인지공능손해월명현.
Objective To investigate the relationship between the cerebral microbleeds (CMBs) and changes of cognitive function,and the possible mechanism of cognitive impairment caused by CMBs.Methods Sixty-eight micro-hemorrhage patients on susceptibility weighted imagine (SWI) sequences composed positive group,and sixty-eight patients selected without micro-hemorrhage in the SWI sequence and meeting the selection criteria as control group.At the same time,both two groups were assessed by MoCA and CDT scale inspection.Results CDT scores of CMBs group (2.00±0.88) were significantly lower than those of control group (3.76±0.53),and there was significantly different in the two groups (t=-3.27,P=0.00).At the same time,MoCA total scores and executive functions,naming,calculation,language,abstraction,recall scores of CMBs group were significantly lower than those of control group,and all of the groups were significantly different (t=-5.48,P=0.00; t=-4.36,P=0.00; t=-2.35,P=0.01 ; t=-2.49,P=0.02; t=-4.09,P=0.00; t=-4.63,P=0.00).CDT scores,MoCA total scores,executive functions,language,abstraction,memory scores between CMBs groups and control group were significantly different at all levels (P＜0.05).Executive functions,languages and calculated inter-group of mild CMBs,moderate CMBs,severe CMBs were significantly different (P＜0.05).The number of CMBs was negative correlation with total scores,executive function,language,and abstract (r=-0.675,P=0.000; r=-0.689,P=0.000; r=-0.536,P=0.000; r=-0.636,P=0.000).Conclusion The existence of CMBs and the number of CMBs are closely related to cognitive dysfunction.The more of CMBs,the more of obvious cognitive impairment.