脑动脉硬化和脑梗死病人认知功能与脑血流速度的观察

Observation of the Cognition and the Velocities of Blood in the Brain in Cerebral Arteriosclerosis and Infarct Patients

目的观察脑动脉硬化(AS)和不同病程时期(<2周;>6月)脑梗死病人认知功能与脑内血液供应状态的变化。方法1)对照组:30例;2)AS组:22例;3)2W组:21例;4)6M组:20例。所有观察对象进行认知电位P300及经颅多普勒超声(TCD)检测、简易精神状态量表(MMSE)评分。结果AS组、2W组、6M组与对照组相比P300潜伏期均显著延长(P<0.01)。6M组与AS组比较P300潜伏期显著延长(P<0.05);2W组和6M组P300波幅均显著小于对照组(P<0.05)。AS组双侧大脑中动脉(MCA)、右侧大脑前动脉(ACA)血流平均速度均显著高于对照组(P<0.05;0.01);2W组左侧MCA血流平均速度显著低于对照组(P<0.05);6M组左侧MCA、右侧ACA和基底动脉血流平均速度均显著低于对照组(P<0.05;0.05;0.01)。MMSE评分各组均显著低于对照组(P<0.01),6M组显著低于AS组(P<0.01)。结论脑动脉硬化和脑梗死病人存在认知异常和脑内血液供应异常,病程延长认知损伤加重。

Objective To observe the change of the cognition and the supply of blood in brain in healthy people and patients with arteriosclerosis(AS) and cerebral infarct. Method 1)control group: healthy people, 30 cases. 2)AS group: 22 cases with cerebral arteriosclerosis. Cerebralvascular infarct patients were divided into two groups. 3)2W group: 21 cases, the patients’ course of disease was shorter than two weeks. 4)6M group: 20 cases, the patients’ course of disease was from six months to four years. All cases were checked with cognitive P300 and transcranial doppler ultrasound(TCD) and mini-mental status examination(MMSE). Result The result revealed that the P300 incubation period in 2W group, 6M group and the AS group was remarkable extend than the control group (P<0.01), meanwhile the period of the 6M group was longer than the AS group (P<0.05); the amplitude of the wave of the 2W group and 6M group were shorter than the control group (P<0.05; 0.05). The velocities of bilateral MCA and right ACA were remarkable improved in AS group(P<0.05;0.01), and the velocities of left MCA both in 2W and 6M group, the right ACA and BA in 6M group were remarkablely decreased than the control group(P<0.05;0.01). The grades of MMSE in all patients were lower than the control group and the grades in 6M group was lower than the AS group. Conclusion There are some changes of the P300 and abnormity of brain blood supply in the cerebral infarct patients and AS patients.The longer the course, the more serious of the cognition with the patients.