国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2013年
2期
86-90
,共5页
王国珍%汪国宏%王小强%张持%岳宏%吴君仓
王國珍%汪國宏%王小彊%張持%嶽宏%吳君倉
왕국진%왕국굉%왕소강%장지%악굉%오군창
卒中%脑缺血%微出血%认知障碍%磁共振成像
卒中%腦缺血%微齣血%認知障礙%磁共振成像
졸중%뇌결혈%미출혈%인지장애%자공진성상
Stroke%Brain Ischemia%Cerebral Hemorrhage%Cognition Disorders%Magnetic Resonance Imaging
目的 探讨急性脑梗死患者认知功能与脑微出血(cerebral microbleed,CMB)的相关性.方法 前瞻性分析急性脑梗死患者的临床和影像学资料,根据MRI结果对CMB进行计数,详细记录患者的一般情况、CMB部位和脑白质疏松严重程度,在入院次日应用蒙特利尔评估量表(Montreal Assessment Scale,MoCA)对患者进行认知功能评估,在3、6和9个月时进行MoCA评估随访.分析急性脑梗死患者的认知功能变化及其与CMB的关系.结果 共纳入82例缺血性卒中患者,其中33例伴有CBM,49例无CBM.CMB组收缩压[(155.03±19.68)mm Hg对(142.20±21.22)mm Hg(1 mm Hg=0.133 kPa)；t=2.762,P=0.007]和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分[(6.21±4.57)分对(4.00±3.98)分；t=2.322,P=0.023]均显著性高于非CMB组.多变量logistic回归分析显示,收缩压水平[优势比(odds ratio,OR)1.032,95％可信区间(confidence interval,CI)1.008～1.057；P=0.009]和NIHSS评分(OR 1.163,95％ CI l.013～1.311;P=0.014)是急性脑梗死患者存在CMB的独立预测因素.CMB与MoCA量表评分密切相关,且随访时间越长,相关性越强.在CMB患者中,执行功能(rs=-0.318,P=0.004)、视空间功能(rs=-0.403,P=0.000)和计算功能(rs=-0.362,P=0.001)均显著受损,CMB越严重,这3个认知域评分越低,损害也越严重.结论 CMB与急性脑梗死患者认知功能损害密切相关,CMB越严重,认知功能损害越明显,且CMB患者的认知功能损害随着时间的推移而加重.
目的 探討急性腦梗死患者認知功能與腦微齣血(cerebral microbleed,CMB)的相關性.方法 前瞻性分析急性腦梗死患者的臨床和影像學資料,根據MRI結果對CMB進行計數,詳細記錄患者的一般情況、CMB部位和腦白質疏鬆嚴重程度,在入院次日應用矇特利爾評估量錶(Montreal Assessment Scale,MoCA)對患者進行認知功能評估,在3、6和9箇月時進行MoCA評估隨訪.分析急性腦梗死患者的認知功能變化及其與CMB的關繫.結果 共納入82例缺血性卒中患者,其中33例伴有CBM,49例無CBM.CMB組收縮壓[(155.03±19.68)mm Hg對(142.20±21.22)mm Hg(1 mm Hg=0.133 kPa)；t=2.762,P=0.007]和美國國立衛生研究院卒中量錶(National Institutes of Health Stroke Scale,NIHSS)評分[(6.21±4.57)分對(4.00±3.98)分；t=2.322,P=0.023]均顯著性高于非CMB組.多變量logistic迴歸分析顯示,收縮壓水平[優勢比(odds ratio,OR)1.032,95％可信區間(confidence interval,CI)1.008～1.057；P=0.009]和NIHSS評分(OR 1.163,95％ CI l.013～1.311;P=0.014)是急性腦梗死患者存在CMB的獨立預測因素.CMB與MoCA量錶評分密切相關,且隨訪時間越長,相關性越彊.在CMB患者中,執行功能(rs=-0.318,P=0.004)、視空間功能(rs=-0.403,P=0.000)和計算功能(rs=-0.362,P=0.001)均顯著受損,CMB越嚴重,這3箇認知域評分越低,損害也越嚴重.結論 CMB與急性腦梗死患者認知功能損害密切相關,CMB越嚴重,認知功能損害越明顯,且CMB患者的認知功能損害隨著時間的推移而加重.
목적 탐토급성뇌경사환자인지공능여뇌미출혈(cerebral microbleed,CMB)적상관성.방법 전첨성분석급성뇌경사환자적림상화영상학자료,근거MRI결과대CMB진행계수,상세기록환자적일반정황、CMB부위화뇌백질소송엄중정도,재입원차일응용몽특리이평고량표(Montreal Assessment Scale,MoCA)대환자진행인지공능평고,재3、6화9개월시진행MoCA평고수방.분석급성뇌경사환자적인지공능변화급기여CMB적관계.결과 공납입82례결혈성졸중환자,기중33례반유CBM,49례무CBM.CMB조수축압[(155.03±19.68)mm Hg대(142.20±21.22)mm Hg(1 mm Hg=0.133 kPa)；t=2.762,P=0.007]화미국국립위생연구원졸중량표(National Institutes of Health Stroke Scale,NIHSS)평분[(6.21±4.57)분대(4.00±3.98)분；t=2.322,P=0.023]균현저성고우비CMB조.다변량logistic회귀분석현시,수축압수평[우세비(odds ratio,OR)1.032,95％가신구간(confidence interval,CI)1.008～1.057；P=0.009]화NIHSS평분(OR 1.163,95％ CI l.013～1.311;P=0.014)시급성뇌경사환자존재CMB적독립예측인소.CMB여MoCA량표평분밀절상관,차수방시간월장,상관성월강.재CMB환자중,집행공능(rs=-0.318,P=0.004)、시공간공능(rs=-0.403,P=0.000)화계산공능(rs=-0.362,P=0.001)균현저수손,CMB월엄중,저3개인지역평분월저,손해야월엄중.결론 CMB여급성뇌경사환자인지공능손해밀절상관,CMB월엄중,인지공능손해월명현,차CMB환자적인지공능손해수착시간적추이이가중.
Objective To investigate the correlation between cognitive function and cerebral microbleeds (CMBs) in patients with acute cerebral infarction.Methods The clinical and imaging findings in patients with acute stroke were analyzed retrospective.CMBs were counted according to the findings of MRI.The general conditions,CMB site and leukoaraiosis severity of the patients were recorded in detail.The cognitive function of the patients was assessed with the Montreal cognitive assessment scale (MoCA) the next day in the hospital.MoCA assessment follow-up was conducted at 3,6 and 9 months.The changes in cognitive function of the patients with acute cerebral infarction and its relationship with CBMs were analyzed.Results A total of 82 patients with ischemic stroke were enrolled in the study,33 of them had CBMs and 49 had no CBMs.The systolic blood pressure (155.03 ± 19.68 mm Hg vs.142.20 ± 21.22 mm Hg;t =2.762,P =0.007) and the National Institutes of Health Stroke Scale (NIHSS) score (6.21 ±4.57 vs.4.00 ±3.98; t =2.322,P =0.023) in the CBM group were significantly higher than those in the non-CBM group.Multivariate logistic regression analysis showed that the systolic blood pressure level (odds ratio [OR] 1.032,95％ confidence interval [CI] 1.008-1.057; P=0.009) and the NIHSS score (OR 1.163,95％ CI 1.013-1.311;P=0.014) were the independent predictors of CBMs in patients with acute cerebral infarction.CMBs were closely associated with MoCA scores,and the longer follow-up time,the correlation would stronger.The executive function (rs =0.318,P =0.004),visual space function (rs =0.403,P =0.000) and calculation function (rs =0.362,P=0.001) in patients with CMBs were significantly impaired.The more serious of CMBs,the lower of the scores in above 3 cognitive domains,and the damage would be more serious.Conclusions CMBs are closely associated with cognitive function impairment in patients with acute cerebral infarction.The more serious of CMBs,the more serious of cognitive function impairment will be,and with the extension of time,cognitive function impairment in patients with CMBs will aggravate.
