CAJ | 학술논문

目的探讨脑白质疏松症对老年患者急性脑梗死后认知功能的影响. 方法选择2010年5月至2011年8月我院神经内科急性脑梗死住院患者147例为研究对象,脑白质疏松组96例,非脑白质疏松组51例.分析各组蒙特利尔认知评估量表(MOCA)和影响认知功能的各个因素.结果脑白质疏松组和非脑白质疏松组一般临床资料比较,差异无统计学意义(P＞0.05)；脑白质疏松与非脑白质疏松组的认知障碍分别为57例(59.4％)和11例(21.6％),差异有统计学意义(x2=19.15,P＜0.01)；关键部位与其他部位梗死的认知障碍分别为68.9％(42/61)和30.2％(26/86),差异有统计学意义(x2 =21.41,P＜0.01)；Logistic回归分析结果显示,关键部位梗死、脑白质疏松与认知障碍密切相关(OR分别为12.25、6.60,均P＜0.01),而梗死面积与脑梗死牛津郡社区脑卒中项目(OCSP)分型对认知障碍无影响；相关分析结果显示,脑白质疏松程度与MOCA评分呈负相关(r=-0.87,P＜0.01). 结论脑梗死部位和脑白质疏松均是影响脑梗死后认知功能的独立危险因素,前者可能起主导作用,后者起次要作用.
목적 탐토뇌백질소송증대노년환자급성뇌경사후인지공능적영향. 방법 선택2010년5월지2011년8월아원신경내과급성뇌경사주원환자147례위연구대상,뇌백질소송조96례,비뇌백질소송조51례.분석각조몽특리이인지평고량표(MOCA)화영향인지공능적각개인소.결과 뇌백질소송조화비뇌백질소송조일반림상자료비교,차이무통계학의의(P＞0.05)；뇌백질소송여비뇌백질소송조적인지장애분별위57례(59.4％)화11례(21.6％),차이유통계학의의(x2=19.15,P＜0.01)；관건부위여기타부위경사적인지장애분별위68.9％(42/61)화30.2％(26/86),차이유통계학의의(x2 =21.41,P＜0.01)；Logistic회귀분석결과현시,관건부위경사、뇌백질소송여인지장애밀절상관(OR분별위12.25、6.60,균P＜0.01),이경사면적여뇌경사우진군사구뇌졸중항목(OCSP)분형대인지장애무영향；상관분석결과현시,뇌백질소송정도여MOCA평분정부상관(r=-0.87,P＜0.01). 결론 뇌경사부위화뇌백질소송균시영향뇌경사후인지공능적독립위험인소,전자가능기주도작용,후자기차요작용.
Objective To explore the effects of leukoaraiosis on cognitive function in elderly patients after acute cerebral infarction.Methods From May 2010 to August 2011,a total of 147 elderly patients with acute cerebral infarction were enrolled,including 96 patients with leukoaraiosis and 51 patients without leukoaraiosis.The Montreal Cognitive Assessment (MOCA) and the correlative factors of cognitive function were assessed in all patients.Results There was no statistical difference in general information between patients with and without leukoaraiosis.There were significant differences in the MoCA scores between patients with and without leukoaraiosis (x2 =19.15,P＜0.01),as well as between the vital and non-vital positions of cerebral infarction (x2=21.41,P＜0.01).The Logistic regression analysis showed that the vital position of infarction and leukoaraiosis were related to the cognitive impairment (OR=12.27,6.60,both P＜0.01),while the area of infarction and the type of cerebral infarction in Oxford County Community Stroke Project (OCSP) had no effects on cognitive impairment.Pearson correlation analysis showed that there was a positive relationship between the degree of white matter lesions and the decline in cognitive function (r=-0.87,P＜0.01).Conclusions The position of acute cerebral infarction and leukoaraiosis are independent risk factors for cognitive function after acute cerebral infarction,and the former plays a more important role than does the latter.