CAJ | 학술논문

目的：评价脑小血管病（ CSVD）引发的脑白质疏松与患者认知功能障碍的关系。方法收集门诊及住院CSVD患者，选取合并脑白质疏松的患者130例作为观察组；选取无神经系统和精神疾病的志愿者122例作为健康对照组。进行颅脑MR扫描，根据年龄相关白质变化分级量表（ ARWMCRs ）将观察组分为轻度亚组42例，中度亚组51例，重度亚组37例。利用简明精神状态量表（ MMSE）和蒙特利尔认知量表（ MoCA）筛选评估认知功能，分析脑白质疏松与患者认知功能障碍的关系。结果 MoCA评分结果显示，观察组视空间与执行能力、注意力、语言能力、抽象能力明显均低于健康对照组（ P ＜0 m．01），而在命名能力、延迟记忆能力和定向力3个认知域中，观察组的评分亦低于健康对照组（ P均＜0．05）。与健康对照组相比，合并脑白质疏松的CSVD患者发生血管性认知障碍的风险明显升高（ RR＝8．2， P ＜0．01），而且白质病变（WML）与认知障碍之间具有较强的相关性（OR＝6．059，95％CI＝2．301～18．728， P ＜0．01）。结论脑小血管病引发的脑白质疏松与患者的认知功能障碍具有相关性。可以通过患者的脑白质病变情况尽早筛查具有轻度认知障碍的患者，预防血管性认知功能障碍。
목적：평개뇌소혈관병（ CSVD）인발적뇌백질소송여환자인지공능장애적관계。방법수집문진급주원CSVD환자，선취합병뇌백질소송적환자130례작위관찰조；선취무신경계통화정신질병적지원자122례작위건강대조조。진행로뇌MR소묘，근거년령상관백질변화분급량표（ ARWMCRs ）장관찰조분위경도아조42례，중도아조51례，중도아조37례。이용간명정신상태량표（ MMSE）화몽특리이인지량표（ MoCA）사선평고인지공능，분석뇌백질소송여환자인지공능장애적관계。결과 MoCA평분결과현시，관찰조시공간여집행능력、주의력、어언능력、추상능력명현균저우건강대조조（ P ＜0 m．01），이재명명능력、연지기억능력화정향력3개인지역중，관찰조적평분역저우건강대조조（ P균＜0．05）。여건강대조조상비，합병뇌백질소송적CSVD환자발생혈관성인지장애적풍험명현승고（ RR＝8．2， P ＜0．01），이차백질병변（WML）여인지장애지간구유교강적상관성（OR＝6．059，95％CI＝2．301～18．728， P ＜0．01）。결론뇌소혈관병인발적뇌백질소송여환자적인지공능장애구유상관성。가이통과환자적뇌백질병변정황진조사사구유경도인지장애적환자，예방혈관성인지공능장애。
Objective To evaluate correlation between cerebral small vessel disease ( CSVD) induced leukoaraiosis and cognitive impairment .Methods Collected outpatient and inpatient CSVD patients ,130 cases complicated with WML were chosen as observation group;Selected 122 health volunteers without neurological and psychiatric disorders as healthy control group.MR brain scans were carried out, according to age-related white matter changes rating scale ( ARWMCRs) ,observa-tion group was divided into 42 cases of mild subgroup, 51 cases of moderate subgroup, 37 cases of severe subgroup .Use Mini-Mental State Examination ( MMSE) and Montreal Cognitive Scale ( MoCA) screening assessment of cognitive function, analyze the relationship between leukoaraiosis and cognitive dysfunction .Results MoCA scores showed that the observation group in the visual space and implementation capacity, attention, language ability, abstract ability was significantly lower than the healthy control group ( P <0.01), whereas in naming ability, disorientation and memory latency, the observation group score was lower than the healthy control group ( P <0.05).Compared with the healthy control group, the risk of the combined leu-koaraiosis CSVD patients with vascular cognitive impairment was significantly higher (RR=8.2, P <0.01), but also there was strong correlation between white matter lesions ( WML) and cognitive impairment ( OR=6.059, 95% CI=2.301 -18.728, P <0.01).Conclusion CSVD induced leukoaraiosis is correlated with cognitive dysfunction ,by detecting white matter lesions in patients with early screening of patients had mild cognitive impairment, prevention of vascular cognitive im-pairment .