CAJ | 학술논문

目的探讨老年腔隙性脑梗死部位与认知功能障碍的关系及随时间发展的趋势。方法选择98例老年腔隙性脑梗死患者，另选同期健康体检的老年人60例为对照组。分别对患者急性期（脑梗死发生3~4周）、12个月、24个月以及对照组采用中文版蒙特利尔认知评估量表（MoCA）进行认知功能评估，观察腔隙性脑梗死部位与认知功能障碍的关系及随时间发展的趋势。结果各部位腔隙性脑梗死患者注意力集中、执行功能得分均显著低于对照组，病变部位在小脑区的患者记忆得分显著低于其他各组，病变部位在大脑皮层的患者命名得分显著低于其他各组，病变部位在小脑区和脑干区的患者定向力得分显著低于其他各组。病变部位在内囊及基底节区、脑干区、大脑皮层区与小脑区的患者抽象思维和语言得分显著低于病变部位在丘脑区的患者和对照组。随访结果发现，各病变部位的患者在24个月随访的 MoCA 得分总分均显著低于急性期的得分。差异均有统计学意义（ P ﹤0.05）。结论老年腔隙性脑梗死患者存在认知功能障碍，其认知功能障碍与梗死的部位相关，且随着病变进展出现缓慢恶化的趋势。
목적탐토노년강극성뇌경사부위여인지공능장애적관계급수시간발전적추세。방법선택98례노년강극성뇌경사환자，령선동기건강체검적노년인60례위대조조。분별대환자급성기（뇌경사발생3~4주）、12개월、24개월이급대조조채용중문판몽특리이인지평고량표（MoCA）진행인지공능평고，관찰강극성뇌경사부위여인지공능장애적관계급수시간발전적추세。결과각부위강극성뇌경사환자주의력집중、집행공능득분균현저저우대조조，병변부위재소뇌구적환자기억득분현저저우기타각조，병변부위재대뇌피층적환자명명득분현저저우기타각조，병변부위재소뇌구화뇌간구적환자정향력득분현저저우기타각조。병변부위재내낭급기저절구、뇌간구、대뇌피층구여소뇌구적환자추상사유화어언득분현저저우병변부위재구뇌구적환자화대조조。수방결과발현，각병변부위적환자재24개월수방적 MoCA 득분총분균현저저우급성기적득분。차이균유통계학의의（ P ﹤0.05）。결론노년강극성뇌경사환자존재인지공능장애，기인지공능장애여경사적부위상관，차수착병변진전출현완만악화적추세。
Objectine To explore the relationship between site and cognitive dysfunction in elderly patients with lacunar infarction and their developing trends. Methods A total of 98 elderly patients with lacunar infarctions were allocated in this study,and 60 elderly healthy volun-teers were enrolled in control group. Chinese edition of the Montreal Cognitive Assessment(MoCA)had been used to evaluate the cognitive func-tion. Relationship between the site of lacunar infarction and cognitive dysfunction had been observed and the development of trends over time had been followed - up. Results In patients with various parts of lacunar infarctions,the scores of executive function were significantly lower than those of control group. In patients with lesions in cerebellum region,memory scores were significantly lower than those of other groups. In patients with lesions in cerebral cortex,scores were significantly lower than those of other groups. In patients with lesions in cerebellar and brainstem re-gions,scores of disorientation were significantly lower than those of other groups. The thinking and language scores in patients with cystic lesions and lesions in basal ganglia,brainstem and cerebellum,cortical area,thinking and language scores were significantly lower than those of patients with lesion in hypothalamus region and control groups. The results of follow - up for 24 months demonstrated that MoCA scores in patients with le-sions at any part were significantly lower than those of patients in acute phase,and their difference was significant( P ﹤ 0. 05). Conclusion Elderly patients with lacunar infarctions exsit cognitive dysfunction,the cognitive impairment in lacunar infarction is correwsponding to the site of infarction in elderly patients,and they have the trend of slow progress of worsening of the disease.