国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2015年
1期
32-37
,共6页
脑出血%认知障碍%卒中,腔隙%脑白质疏松%脑小血管疾病%危险因素
腦齣血%認知障礙%卒中,腔隙%腦白質疏鬆%腦小血管疾病%危險因素
뇌출혈%인지장애%졸중,강극%뇌백질소송%뇌소혈관질병%위험인소
Cerebral Hemorrhage%Cognition Disorders%Stroke,Lacunar%Leukoaraiosis%Cerebral Small Vessel Diseases%Risk Factors
目的 检测腔隙性梗死(lacunar infarction,U)和(或)脑白质疏松(leukoaraiosis,LA)患者脑微出血(cerebral microbleeds,CMBs)的分布,分析CMBs相关的危险因素和与认知损害的相关性.方法 38例U和(或)LA患者根据磁敏感加权成像结果分为CMBs组和非CMBs组,记录各脑区CMBs病灶数量,应用简易智能状态检查量表(Mini-Mental State Examination,MMSE)和蒙特利尔认知评定量表(Montreal Cognitive Assessment,MoCA)进行认知功能测验,并且根据MoCA评分将患者分为认知损害组和非认知损害组.对各组人口统计学和临床资料进行比较,确定CMBs以及认知损害的独立危险因素.结果 CMBs组13例,共有CMBs灶58个,其分布为基底节及丘脑36个、皮质及皮质下14个、脑干3个、小脑5个,非CMBs组25例;认知损害组26例,非认知损害组12例.CMBs组年龄以及高血压、服用抗栓药和伴有LA的患者比例与非CMBs组存在统计学差异(P均＜0.05).多变量logistic回归分析显示,只有高龄为CMBs的独立危险因素(优势比1.103,95％可信区间1.034～1.454;P =0.045).CMBs组MMSE[(26.92 ±2.87)分对(29.00±1.44)分;t=-2.452,p=0.027]和MoCA[(21.62±3.36)分对(25.04±2.59)分;t=-3.493,P=0.001]评分均显著低于非CMBs组.认知损害组仅CMBs数量与非认知损害组存在统计学差异[(2.08±3.64)个对(0.33±0.78)个;t=-1.629,P=0.010],多变量logistic回归分析显示,仅CMBs数量是认知损害的独立危险因素(优势比1.534,95％可信区间1.100 ～2.576;P=0.046).Spearman等级相关分析显示,CMBs数量与MoCA的语言(r=-0.229,P=0.003)和延迟回忆(r=-0.332,P=0.042)评分呈显著负相关.结论 在LI和(或)LA患者中,CMBs与年龄相关,其存在和数量与认知功能损害相关.
目的 檢測腔隙性梗死(lacunar infarction,U)和(或)腦白質疏鬆(leukoaraiosis,LA)患者腦微齣血(cerebral microbleeds,CMBs)的分佈,分析CMBs相關的危險因素和與認知損害的相關性.方法 38例U和(或)LA患者根據磁敏感加權成像結果分為CMBs組和非CMBs組,記錄各腦區CMBs病竈數量,應用簡易智能狀態檢查量錶(Mini-Mental State Examination,MMSE)和矇特利爾認知評定量錶(Montreal Cognitive Assessment,MoCA)進行認知功能測驗,併且根據MoCA評分將患者分為認知損害組和非認知損害組.對各組人口統計學和臨床資料進行比較,確定CMBs以及認知損害的獨立危險因素.結果 CMBs組13例,共有CMBs竈58箇,其分佈為基底節及丘腦36箇、皮質及皮質下14箇、腦榦3箇、小腦5箇,非CMBs組25例;認知損害組26例,非認知損害組12例.CMBs組年齡以及高血壓、服用抗栓藥和伴有LA的患者比例與非CMBs組存在統計學差異(P均＜0.05).多變量logistic迴歸分析顯示,隻有高齡為CMBs的獨立危險因素(優勢比1.103,95％可信區間1.034～1.454;P =0.045).CMBs組MMSE[(26.92 ±2.87)分對(29.00±1.44)分;t=-2.452,p=0.027]和MoCA[(21.62±3.36)分對(25.04±2.59)分;t=-3.493,P=0.001]評分均顯著低于非CMBs組.認知損害組僅CMBs數量與非認知損害組存在統計學差異[(2.08±3.64)箇對(0.33±0.78)箇;t=-1.629,P=0.010],多變量logistic迴歸分析顯示,僅CMBs數量是認知損害的獨立危險因素(優勢比1.534,95％可信區間1.100 ～2.576;P=0.046).Spearman等級相關分析顯示,CMBs數量與MoCA的語言(r=-0.229,P=0.003)和延遲迴憶(r=-0.332,P=0.042)評分呈顯著負相關.結論 在LI和(或)LA患者中,CMBs與年齡相關,其存在和數量與認知功能損害相關.
목적 검측강극성경사(lacunar infarction,U)화(혹)뇌백질소송(leukoaraiosis,LA)환자뇌미출혈(cerebral microbleeds,CMBs)적분포,분석CMBs상관적위험인소화여인지손해적상관성.방법 38례U화(혹)LA환자근거자민감가권성상결과분위CMBs조화비CMBs조,기록각뇌구CMBs병조수량,응용간역지능상태검사량표(Mini-Mental State Examination,MMSE)화몽특리이인지평정량표(Montreal Cognitive Assessment,MoCA)진행인지공능측험,병차근거MoCA평분장환자분위인지손해조화비인지손해조.대각조인구통계학화림상자료진행비교,학정CMBs이급인지손해적독립위험인소.결과 CMBs조13례,공유CMBs조58개,기분포위기저절급구뇌36개、피질급피질하14개、뇌간3개、소뇌5개,비CMBs조25례;인지손해조26례,비인지손해조12례.CMBs조년령이급고혈압、복용항전약화반유LA적환자비례여비CMBs조존재통계학차이(P균＜0.05).다변량logistic회귀분석현시,지유고령위CMBs적독립위험인소(우세비1.103,95％가신구간1.034～1.454;P =0.045).CMBs조MMSE[(26.92 ±2.87)분대(29.00±1.44)분;t=-2.452,p=0.027]화MoCA[(21.62±3.36)분대(25.04±2.59)분;t=-3.493,P=0.001]평분균현저저우비CMBs조.인지손해조부CMBs수량여비인지손해조존재통계학차이[(2.08±3.64)개대(0.33±0.78)개;t=-1.629,P=0.010],다변량logistic회귀분석현시,부CMBs수량시인지손해적독립위험인소(우세비1.534,95％가신구간1.100 ～2.576;P=0.046).Spearman등급상관분석현시,CMBs수량여MoCA적어언(r=-0.229,P=0.003)화연지회억(r=-0.332,P=0.042)평분정현저부상관.결론 재LI화(혹)LA환자중,CMBs여년령상관,기존재화수량여인지공능손해상관.
Objective To detect the distribution of cerebral microbleeds (CMBs) in patients with lacunar infarction (LI) and/or leukoaraiosis (LA) and to analyze the correlation between the CMB related risk factors and cognitive impairment.Methods Thirty-eight patients with LI and/or LA were divided into either a CMB group or a non-CMB group according to the findings of susceptibility weighted imaging.The number of CMB lesions was recorded.Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were used to conduct cognitive function tests,and the patients were also divided into a cognitive impairment group and a non-cognitive impairment group according to the MoCA scores.The demographic and clinical data in each group were compared.The independent risk factors for CMBs and cognitive impairment were identified.Results Thirteen patients had 58 CMBs in the CMB group.Their distributions were as follows:36 CMBs in basal ganglia and thalamus,14 in cortical and subcortical regions,3 in brain stem,and 5 in cerebellum.There were 25 patients in the non-CBM group,26 in the cognitive impairment group,and 12 in the non-cognitive impairment group.There were significant differences in age and the proportions of hypertension,taking antithrombotic drugs and the patients with LA between the CMB group and the non-CMB group (all P ＜ 0.05).Multivariable logistic regression analysis showed that only age was an independent risk factor for CMBs (odds ratio 1.103,95％ confidence interval 1.034-1.454; P =0.045).MMSE (26.92±2.87vs.29.00± 1.44; t=2.452,P=0.027) and MoCA (21.62±3.36vs.25.04 ± 2.59; t =-3.493,P =0.001) scores in the CMB group were significantly lower than those in the non-CMB group.There was only significant difference in the number of CMBs between the cognitive impairment group and the non-cognitive impairment group (2.08-± 3.64 vs.0.33 ±0.78; t =-1.629,P =0.010).Multivariate logistic regression analysis showed that only the number of CMBs was an independent risk factor for cognitive impairment (odds ratio,1.534,95％ confidence interval 1.100-2.576; P=0.046).Spearman rank correlation analysis showed that the number of CMBs was significantly negatively correlated with the MoCA language (r =-0.229,P=0.003) and the delayed recall (r =-0.332,P=0.042) scores.Conclusions In patients with LI and/or LA,CMBs were correlated with age.Their existence and number were associated with cognitive impairment.
