脑血管病患者不同部位损伤对再认记忆的影响

Recognitive characteristics in patients with cerebrovascular disease in different cerebral areas

目的探讨脑血管病不同部位损伤对再认记忆的影响。方法脑血管病组（共70例，按损伤脑区不同分为基底节区损伤组、额叶损伤组、颞叶损伤组，按损伤灰质、白质不同可分为皮层损伤组、皮层下损伤组，按损伤不同半球分为左半球损伤组、右半球损伤组）与对照组（共75例）在微机上完成双字词及无意义图形再认两项测验，观察脑血管病不同部位损伤患者再认成绩的差异及脑血管病组与对照组再认成绩的差异。结果脑血管病组双字词及无意义图形再认测验成绩[（10．13±2．72）分，（9．50±3．02）分]均显著低于正常对照组[（12．96±2．97）分，（13．35±2．56）分]（t值分别为5．98和8．30，均P〈0．01），皮层损伤组[（9．08±2．11）分，（8．26±2．72）分]低于皮层下损伤组[（11．38±2．86）分，（10．97±2．72）分]（t值分别为3．86和4．15，均P〈0．01）；左半球损伤组双字词再认成绩[（9．33±2．61）分]显著低于右半球损伤组[（10．84±2．65）分]（t=2．39，P〈0．05）；基底节区损伤组、额叶损伤组、颞叶损伤组3组比较，2项测验成绩差异均有显著性（F值分别为10．00和11．64，均P〈0．01）；颞叶损伤组两项再认测验成绩[（8.30±2．08）分，（7．35±2．83）分]均显著低于基底节区[（11．38±2．86）分，（10．97±2．72）分]及额叶损伤组[（9．94±1．83）分，（9．28±2．24）分]（P〈0．01，P〈0．05），额叶损伤组2项测验成绩[（9．94±1．83）分，（9．28±2．24）分]均显著低于基底节区损伤组[（11．38±2．86）分，（10．97±2．72）分，均P〈0．05]。结论脑血管病不同部位损伤患者有明显再认记忆障碍，皮层损伤组较皮层下损伤组再认记忆障碍严重，颞叶损伤组再认记忆障碍最重。

Objective To study the recognition in patients with cerebrovascular disease in different areas. Methods The recognitive tests including Chinese words recognizing test and nonsense pictures recognizing test were accomplished in computer, and the differences of recognitive functions between patients with cerebrovascular disease （70 cases, they divided into basal ganglia damaged group, frontal lobe damaged group and temporal lobe damaged group according to damaged brain areas;divided into cortex group and under cortex group according to damaged gray matter or white matter; divided into left and right hemisphere groups according to different damaged hemispheres） and normal controls（75 cases） were compared. The scores of patients with eerebrovascular disease in different cerebral areas were compared too. Results The two scores of the Chinese words recognizing test and nonsense pictures recognizing test in patients with cerebrovascular disease （10.13 ± 2.72,9.50 ± 3.02） were significantly lower than that in normal controls （ 12.96 ± 2.97,13.35 ± 2.56） （ t 1= 5.98, t 2= 8.30, both P 〈 0.01 ）, and in patients with cerebrovascular disease focuses in cortex （9.08 ± 2.11,8.26 ± 2.72）were lower than that in patients with cerebrovascular disease focuses in under cortex （ 11.38 ± 2.86,10.97 ± 2.72 ） （ t 1= 3.86, t 2= 4.15, both P〈0.01 ）;the scores of Chinese characters recognizing test in patients with left hemisphere lesion（9.33 ± 2.61 ） was lower than that in patients with right hemisphere lesion（ 10.84 ± 2.65 ） （ t 1= 2.39, P 〈 0.05）. The scores of all tests in patients with cerebrovascular disease focuses in basal ganglia, frontal lobe and temporal lobe were significantly different（ F 1= 10.00, F 2 = 11.64, both P 〈 0.01 ）. The scores of the two tests in patients with cerebrovascular disease focuses in temporal lobe（8.30± 2.08,7.35 ± 2.83 ）were lower than that in patients with cerebrovascular disease focuses in basal ganglia （11.38 ± 2.86,10.97 ± 2.72 ） and frontal lobe （9.94 ± 1.83, 9.28 ± 2.24） （P 〈 0.01, P 〈 0.05 ） ; the scores of the two tests in patients with cerebrovascular disease focuses in frontal lobe（9.94 ± 1.83,9.28 ±2.24） were lower than that in patients with cerebrovascular disease focuses in basal ganglia（11.38 ±2.86,10.97±2.72） （P〈0.05）. Conclution The disturbances of recognition were observed in patients with cerebrovascular disease, The disturbances of recognition in patients with cerebrovascular disease focuses in cortex were more serious than that in patients with cerebrovascular focuses in under cortex; the disturbances in patients with temporal lobe lesion were most serious.