缺血性卒中后认知功能减退的神经心理学特征

Study of neuropsychological characteristics of cognitive function impairment after ischemic stroke

目的:研究脑梗死后认知功能减退的神经心理学特点。方法:对脑梗死非痴呆74例住院患者应用简易智能状态检查量表(MMSE)和蒙特利尔认知评估量表(北京版)(MoCA量表)在Jorms Korten(IQCODE)问卷筛查后于发病第14天、1个月、3个月时间点评定认知功能。结果:发病1个月内由评价结果表明MoCA量表敏感性优于MMSE量表。于发病3个月视空间试验、交替连线试验、画钟试验合并缺损的人数最多,在发病3个月内持续高水平且较其他项目改善偏慢。结论:脑梗死发病初期即存在一定程度的认知功能损害,很可能以执行功能、视空间结构技能及图形描画能力、逻辑能力受损为主要特征。

Objective To study neuropsychological characteristics of cognitive function impairment after ischemic stroke. Methods The cognitive function in 74 hospital patients with cerebral infarction but no dementia, were evaluated with Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA） Beijing Version after IQCODE screens at different phase points of 14 days, a month and 3 months after hospital admission or onset. Results In terms of the mutual comparison of MMSE and MoCA during a month after stroke, MoCA was more sensitive than MMSE aiming at cognitive function impairment after cerebral infarction. Patients not achieving full mark of the visuospatial/exeeutive, cube-copying and clock-drawing were accounted for the largest number. They remained rather higher levels during 3 months and declined tardily in contrast with the others according to array and analysis of numeric condition of each component of MoCA. Conclusion There is an extent degree of early cognitive function impairment at the onset of cerebral infarction, which mostly presents as damage of performance ability, apprehension, vision space, portrayal of figure and logical capability.