CAJ | 학술논문

目的探讨脑血管狭窄或闭塞与认知功能损害的关系.方法为病例对照研究.病例组:纳入有脑供血动脉狭窄或闭塞患者,并经磁共振成像或电子计算机体层扫描检查证实脑内无梗死病灶,共45例.对照组:无脑血管狭窄、无脑内病灶的社区人群,共59名.高血压组:确诊高血压而无脑血管狭窄及无脑内病灶的社区人群,共36例.糖尿病组:确诊糖尿病而无脑血管狭窄及无脑内病灶的社区人群,共34例.对各组分别进行注意力、定向力、记忆力、执行功能、信息处理速度、视空间能力及视觉结构能力等方面的测试.结果病例组的多个认知域差于对照组、高血压组及糖尿病组,以言语性记忆测查(正确回忆的单词个数)中的即刻回忆(对照组56.8 ±6.5；病例组48.5±10.1；高血压组53.5±9.0；糖尿病组55.9±7.9；t=-3.57 ～4.822,P=0.000 ～0.021)下降明显,在简化Rey复杂图形记忆方法的即刻回忆和长时延迟回忆,以及执行功能的加利福尼亚卡片分类测验等方面的成绩也明显下降.病例组中单支血管狭窄患者的简化Rey复杂图形长时延迟记忆、数字符号、图片排列等方面测试成绩要好于多支血管狭窄患者,差异有统计学意义.结论脑血管狭窄或闭塞患者存在认知功能损害,且不能用血管危险因素来解释.多支血管狭窄的患者认知功能损害严重.认知功能减退与血管狭窄或闭塞导致的慢性脑血流降低密切相关.
목적 탐토뇌혈관협착혹폐새여인지공능손해적관계.방법 위병례대조연구.병례조:납입유뇌공혈동맥협착혹폐새환자,병경자공진성상혹전자계산궤체층소묘검사증실뇌내무경사병조,공45례.대조조:무뇌혈관협착、무뇌내병조적사구인군,공59명.고혈압조:학진고혈압이무뇌혈관협착급무뇌내병조적사구인군,공36례.당뇨병조:학진당뇨병이무뇌혈관협착급무뇌내병조적사구인군,공34례.대각조분별진행주의력、정향력、기억력、집행공능、신식처리속도、시공간능력급시각결구능력등방면적측시.결과 병례조적다개인지역차우대조조、고혈압조급당뇨병조,이언어성기억측사(정학회억적단사개수)중적즉각회억(대조조56.8 ±6.5；병례조48.5±10.1；고혈압조53.5±9.0；당뇨병조55.9±7.9；t=-3.57 ～4.822,P=0.000 ～0.021)하강명현,재간화Rey복잡도형기억방법적즉각회억화장시연지회억,이급집행공능적가리복니아잡편분류측험등방면적성적야명현하강.병례조중단지혈관협착환자적간화Rey복잡도형장시연지기억、수자부호、도편배렬등방면측시성적요호우다지혈관협착환자,차이유통계학의의.결론 뇌혈관협착혹폐새환자존재인지공능손해,차불능용혈관위험인소래해석.다지혈관협착적환자인지공능손해엄중.인지공능감퇴여혈관협착혹폐새도치적만성뇌혈류강저밀절상관.
Objective To explore the relationship between cerebrovascular steno-occlusive disease and neuropsychological performance by cognitive function assessment.Methods Using a case-control study,45 patients with cerebrovascular steno-occlusive lesions (patient group) and 59 control subjects without cerebrovascular steno-occlusive disease were included,36 simple hypertension (hypertension group)and 34 simple diabetes mellitus subjects (diabetes mellitus group) without cerebrovascular steno-occlusive disease were also included.A battery of neuropsychological was performed in all subjects.The test battery included tests of memory,executive functions,mental speed,visuospatial ability and visuoconstructive skill,anxietas and depression.Results Patient group showed impairments in multiple cognitive domains compared with other three groups.The immediate recall of auditory verbal learning test (controls 56.8 ± 6.5 ;patient group 48.5 ± 10.1 ;hypertension group 53.5 ±9.0 ;diabetes mellitus group 55.9 ± 7.9;t =-3.57-4.822,P =0.000-0.021) were impaired seriously.Moreover,visual memory Modified Rey-Osterrieth Complex Figure Test immediate recall,long time delayed recall and executive function California cards sorting test were also impaired.Patient group was divided into two subgroups,and neuropsychological tests of these subgroups were compared.Multiple stenosis subgroup had significantly worse performance in tests of verbal memory and some executive functions than the single artery stenosis subgroup.Conclusions Cerebrovascular steno-occlusive disease was associated with poorer neuropsychological performance,which could not be explained by vascular risk factors.Multiple stenosis subgroup had lower performance levels in neuropsychological tests than simple stenosis subgroup.Ischemia or hypoperfusion caused by steno-occlusive disease might be responsible for these cognitive impairments.