中国卒中杂志
中國卒中雜誌
중국졸중잡지
CHINESE JOURNAL OF STROKE
2015年
9期
740-745
,共6页
周凯歌%吴雄枫%郑惠文%丁素菊%李海龙%黎佳思%毕晓莹
週凱歌%吳雄楓%鄭惠文%丁素菊%李海龍%黎佳思%畢曉瑩
주개가%오웅풍%정혜문%정소국%리해룡%려가사%필효형
皮层下脑梗死%脑白质变性%认知评估
皮層下腦梗死%腦白質變性%認知評估
피층하뇌경사%뇌백질변성%인지평고
subcortical infarction%white matter change%cognitive assessment
目的：分析皮层下脑梗死所致血管性认知障碍（subcorticalvascular cognitive impairment，SVCI）脑白质变性与认知功能评分的相关性。方法连续入组皮层下脑梗死患者91例，根据神经心理学蒙特利尔认知评估（Montreal Cognitive Assessment，MOCA）分为皮层下脑梗死所致血管性认知障碍（subcortical vascular cognitive impairment， SVCI）组（49例）和无认知障碍的皮质下梗死（subcortical infarcts，SI）组（42例），分析其临床、认知障碍、神经影像学特征，并探讨认知障碍与白质损伤的相关性。结果 SVCI组糖尿病发病率高于SI组（38.78%vs 16.67%，P=0.02），SVCI组脑白质病变患者37例（75.51%）。脑白质损害程度与MOCA执行功能（Rs=-0.415，P=0.028）、瞬时记忆（Rs=-0.577， P=0.001）、注意（Rs=-0.382，P=0.001）、延迟记忆（Rs=-0.389，P=0.041）等4个分量表以及MOCA量表总分（Rs=-0.495，P=0.002）成负相关。结论 SVCI患者糖尿病比例高于SI患者，白质病变多见，且白质病变的程度可以反映不同程度的认知损害。
目的：分析皮層下腦梗死所緻血管性認知障礙（subcorticalvascular cognitive impairment，SVCI）腦白質變性與認知功能評分的相關性。方法連續入組皮層下腦梗死患者91例，根據神經心理學矇特利爾認知評估（Montreal Cognitive Assessment，MOCA）分為皮層下腦梗死所緻血管性認知障礙（subcortical vascular cognitive impairment， SVCI）組（49例）和無認知障礙的皮質下梗死（subcortical infarcts，SI）組（42例），分析其臨床、認知障礙、神經影像學特徵，併探討認知障礙與白質損傷的相關性。結果 SVCI組糖尿病髮病率高于SI組（38.78%vs 16.67%，P=0.02），SVCI組腦白質病變患者37例（75.51%）。腦白質損害程度與MOCA執行功能（Rs=-0.415，P=0.028）、瞬時記憶（Rs=-0.577， P=0.001）、註意（Rs=-0.382，P=0.001）、延遲記憶（Rs=-0.389，P=0.041）等4箇分量錶以及MOCA量錶總分（Rs=-0.495，P=0.002）成負相關。結論 SVCI患者糖尿病比例高于SI患者，白質病變多見，且白質病變的程度可以反映不同程度的認知損害。
목적：분석피층하뇌경사소치혈관성인지장애（subcorticalvascular cognitive impairment，SVCI）뇌백질변성여인지공능평분적상관성。방법련속입조피층하뇌경사환자91례，근거신경심이학몽특리이인지평고（Montreal Cognitive Assessment，MOCA）분위피층하뇌경사소치혈관성인지장애（subcortical vascular cognitive impairment， SVCI）조（49례）화무인지장애적피질하경사（subcortical infarcts，SI）조（42례），분석기림상、인지장애、신경영상학특정，병탐토인지장애여백질손상적상관성。결과 SVCI조당뇨병발병솔고우SI조（38.78%vs 16.67%，P=0.02），SVCI조뇌백질병변환자37례（75.51%）。뇌백질손해정도여MOCA집행공능（Rs=-0.415，P=0.028）、순시기억（Rs=-0.577， P=0.001）、주의（Rs=-0.382，P=0.001）、연지기억（Rs=-0.389，P=0.041）등4개분량표이급MOCA량표총분（Rs=-0.495，P=0.002）성부상관。결론 SVCI환자당뇨병비례고우SI환자，백질병변다견，차백질병변적정도가이반영불동정도적인지손해。
Objective To investigate the association between white matter changes of subcortical infarction vascular cognitive impairment and cognitive assess scores. Methods Ninety-one patients with subcortical infarction were consecutively recruited. According to Montreal cognitive assessment(MOCA), they were divided into two groups as subcortical vascular cognitive impairment group (SVCI, 49 cases) and subcortical infarction without cognitive impairment group (SI, 42 cases). The correlation between Cognitive impairment and white matter lesions by analysis the clinical, cognitive impairment and neuroimaging characteristics of patients were explored. Results The incidence of diabetes in SVCI patients is higher than SI patients (38.78%vs 16.67%,P=0.02). Cerebral white matter changes were found in 37 cases (75.51%) of SVCI patients. There is a negative correlation between the degree of white matter lesion and visuospatial executive(Rs=-0.415,P=0.028), memory(Rs=-0.577,P=0.001), attention(Rs=-0.382,P=0.001), delay recall(Rs=-0.389,P=0.041) according to MOCA assessment (Rs=-0.495,P=0.002). Conclusion Diabetes is an important risk factor in SVCI patients. White matter change is the most important imaging features, and relfects the degree of cognitive impairment.
