脑血管病与血管性认知障碍的相关性研究

Research on the relation between cerebrovascular disease and vascular cognitive impairment

目的探讨脑血管病及其危险因素与血管性认知障碍(VCI)的相关性。方法选择急性脑血管病患者231例,脑血管病急性期后,根据神经认知行为量表评分分为VCI组(82例)和对照组(149例),对2组的性别、年龄、脑血管病危险因素、脑血管病所致损伤(包括急性病变、陈旧病变及腔隙灶)的部位、大小及损伤结构的总数进行比较。结果VCI组平均年龄明显高于对照组(P<0.01);腔隙性脑血管病、大面积病变及双侧大脑半球的病变与VCI的发病有关;性别、高血压、糖尿病、心律失常、高脂血症、脑萎缩不是VCI直接的危险因素。除基底节损伤外,脑血管病其他损伤均与VCI发病无关。结论VCI是一种与隐匿性脑血管病高度相关的老年性疾病,大面积病变及双侧大脑半球的病变会加重认知功能的损害。

Objective To investigate the relation between cerebrovascular disease,its risk factors and vascular cognitive impairment（VCI）. Methods 231 patients with acute cerebrovascular disease were selected. After the acute phase,they were divided into VCI group（82 cases） and control group（149 cases） according to the neurobehavioral cognitive status examination. The gender,age, risk factors for cerebrovascular disease,the injury location, size and total number of injured struc- tures caused by cerebrovascular disease （including acute, old and lacunar lesions） of the two groups were compared. Results The average age of VCI group was significantly higher than that of the control group （P〈 0.01）. The lacunar cerebrovascular disease and lesions of large areas and bilateral hemispheres were related to the morbidity of VCI. The gender,hypertension, diabetes, arrhythmia,hyperlipoidemia and cerebral atrophy were not the direct risk factors for VCI. Except the basal ganglia injury,there was no relationship between the morbidity of VCI and lesions of other parts of the brain. Conclusion VCI is a kind of disease related to the occult cerebrovascular disease and advanced age. Large lesions and bilateral lesions of the cerebral hemisphere will aggravate the impairment of cognitive function.