脑动脉狭窄患者认知功能障碍的研究

Studying on cognitive impairment of patients with cerebral arterial stenosis

目的探讨脑动脉狭窄与认知功能障碍之间的关系。方法采用成人韦氏记忆测验(WMS)、成人韦氏智力量表(WAIS-RC)对72例脑动脉狭窄患者及18例健康者进行认知功能评估。结果记忆商(MQ)：椎-基底动脉狭窄组[(73．29±26．77)分]较颈内动脉狭窄组[(86．38±21．96)分]减退明显(P＜0．05),智商(IQ)：颈内动脉狭窄组[(72．25±23．46)分]较椎-基底动脉狭窄组[(80．65±25．22)分]减退明显(P＜0．05)。动脉狭窄各组的记忆功能和认知功能均较对照组差(P＜0．05),其中颈动脉狭窄组以领悟、算术、相似性、数字符号、填图、木块图等检测减退为主,椎-基底动脉狭窄组以背数、词汇、图形拼凑等检测减退为主(P＜0．01),而全脑动脉狭窄组的记忆认知功能减退是全面的。结论脑动脉狭窄与认知功能密切相关,动脉狭窄类型不同,引起的认知功能障碍类型不同。

Objective Studying relationship between cerebral arterial stenosis and cognitive impairment. Methods Using Wechsler Memory Scale （WMS） and Wechsler Adult Intelligence Scale（WAIS-RC） to evaluate cognitive ability of 72 patients with various type of cerebral arterial stenosis and 18 health adults, so as to discussing the influence of various type of cerebral arterial stenosis to cognitive ability. Results The ability of memory and cognitive of every type of arterial stenosis has declined compared with control group, and the difference is significant（ P 〈 0.05 ）. The decline degree of MQ of vertebrobasilar arterial stenosis group（73.29 ± 26.77points） is more obvious than that of internal carotid arterial stenosis group （ 86.38 ± 21.96 points ） （ P 〈 0.05 ）, while the decline degree of IQ of internal carotid arterial stenosis group（72.25 ± 23.46 points） is more obvious than that of vertebrabasilar arterial stenosis group （80.65 ± 25.22 points）（ P 〈 0.05 ）. The memory ability of every group of arteriostenosis is less than that of control group （ P 〈 0.05 ）. The main manifestation of memory decline of carotid arterial stenosis group is on orientation, association, and picture memory, while that is on counting, logic memory range, vision regeneration, recognize, thigmesthesia （ P 〈 0.01 ） of vertebrobasilar arterial stenosis group （ P 〈 0.01 ）. The memory ability decline of whole cerebral arterial stenosis group（64.25 ± 24.96 points） is generalization and the difference between it and control group （ 104.25 ± 17.38 points） is significant（ P〈0.01 ）. The cognitive ability of every group of arteriostenosis is less than that of control group（ P〈 0.05 ）. The chief manifestation of cognitive impairment of carotid arterial stenosis group is on apprehension, arithmetic calculation, digitymbol test, picture completion test and block chart check ability, while that of vertebrobasilar arterial stenosis group is on numbers recitation ,words, picture arrangement test and so on（ P 〈 0.01 ）. The cognitive impairment of whole cerebral arterial stenosis group （67.38 ± 26.78 points ）is all-round, the difference is obviously compared with the control group（ 108.25 ± 19.68 points） （ P 〈 0.01 ）. Conclusion Cerebral arterial stenosis has closely relationship with cognitive impairment, and different type of arteriostenosis differs from different type of cognitive impairment.