初次发病的腔隙性脑梗死患者认知功能评价

Cognitive Function in Patients with First Lacunar Infarct

目的对初次发病的腔隙性脑梗死患者的认知功能障碍及其影响因素进行评价。方法对96例初次发病的腔隙性脑梗死患者和40名对照者进行简易精神状态量表(MMSE)、数字广度测验(DST)、词语流畅性测验(VFT)和画钟测验(CDT)测评。结果腔隙性脑梗死患者的MMSE、DST、VFT和CDT评分均低于对照组(P<0.05)。患者中37例(38.5%)有认知障碍。与单发病灶组比较,多发病灶组的MMSE、DST、VFT和CDT评分减低(P<0.05);与其他部位梗死组比较,额叶、丘脑及基底节梗死组的MMSE、DST、VFT和CDT评分减低(P<0.05);与无血管危险因素组相比,有血管危险因素组患者的MMSE评分减低(P<0.05)。结论腔隙性脑梗死患者存在认知功能障碍。病灶数目、病灶部位和血管危险因素都是影响认知功能的重要因素。

Objective To evaluate the cognitive impairment and the related factors in patients after first lacunar infarct（LI）.Methods96 patients with LI and 40 controls were assessed with mini-mental state examination（MMSE）,digit span test（DST）,verbal fluency test（VFT）and clock drawing test（CDT）.ResultsThe scores of MMSE,DST,VFT and CDT were significantly lower in LI group than in control group（P〈0.05）.Cognitive impairment occurred in 37（38.5%）patients with LI after first stroke.The scores of MMSE,DST,VFT and CDT were lower in the patients with multiple infarcts than with single infarct（P〈0.05）,and lower in patients with infarcts affecting the frontal lobe,thalamus and basal ganglia than affecting other area（P〈0.05）.The scores of MMSE were lower in the patients with prior vascular risk factors than without risk factors（P〈0.05）.ConclusionLacunar infarction usually leads to cognitive impairment.Cognitive function is associated with multiple infarcts,lesions affecting the frontal lobe,thalamus and basal ganglia and those with prior vascular risk factors.