多发性硬化患者的认知功能障碍及其与头颅MRI病灶的相关性

Relationship between cognitive impairment and brain MRI abnormalities in patients with multiple sclerosis

目的 研究多发性硬化 (MS)患者认知功能障碍的特点及其与头颅MRI病灶的相关性。方法 对 70例MS患者进行韦氏智力量表 (WAIS)测试及头颅MRI检查 ,并用多元回归分析方法对各相关因素进行分析。结果 MS组全量表智商 (FIQ)异常 (<90分 )率为 4 0 %(2 8/70 ) ,与对照组比较差异有显著性 (P <0 0 1)。对智商成绩影响最显著的因素为病变部位 (脑部病变 )。MRI显示病灶的等级与病程呈显著正相关(r=0 348,P <0 0 5 ) ,胼胝体病灶数与FIQ呈负相关 (r=- 0 2 8,P <0 0 5 ) ,其他均无显著相关性 (均P >0 0 5 )。结论 MS患者存在认知障碍 ,MS的病变部位 (脑部病变 )对智能影响最显著 ,头颅MRI所示病灶与MS患者的认知障碍的相关性大多不显著。

Objective To investigate the characteristics of cognitive dysfunction in patients with multiple sclerosis (MS), as well as the correlations between cognitive dysfunction and lesions of brain on MRI.Methods 70 patients with MS were tested with Wechsler Intelligence Scale and brain MRI.A multiple-regression analysis was carried out on the basis of related factors.Results The rate of the patients whose full intelligence quotient(FIQ) less than 90 scores was 40%(28/70), which was higher than that of normal group( P<0.01). In all related factors, the location of lesion was by far the strongest influence on IQ. MRI showed the grade of lesion was positively correlated with the duration of the disease( r=0.348, P<0.05). There was a negative correlation between the numbers of lesion in corpus callosum and FIQ( r= -0.28, P< 0.05). No other significant correlations were found between cognitive dysfunction and lesions of brain on MRI.Conclusion Cognitive impairment is a common occurrence in MS. The location of lesion is by far the strongest influence on IQ. The relationship between cognitive dysfunction and conventional MRI parameters in MS is moderate.