血管性痴呆患者执行功能与脑白质病变的相关性

Correlation exploration between executive function and white matter lesions in patients with vascular dementia

目的应用画钟测验（CDT）检测血管性痴呆（VaD）患者的执行能力，探讨其与头颅磁共振（MRI）白质病变的相关性。方法对27例VaD患者和25例认知正常老年人进行自发画钟测验，评估其执行能力；同时依据年龄相关白质改变的评分方法（ARWMCrs）分别对受试者头颅MRI白质病变程度进行评分。结果1．认知正常组CDT评分高于VaD组，差异具有显著性[分别为（3．88±0．33）分，（1．74±0．98）分，Z=6．26，P〈0．01]。VaD组中数字部分、指针部分评分下降最明显；2．认知正常组与VaD组脑白质病变评分差异具有显著性[分别为（5．12±4．19）分，（11．19±3．09）分，Z=-4．54，P〈0．01]；3．CDT与简明精神状态检查量表（MMSE）得分呈显著正相关（P〈0．01），与白质病变得分呈显著负相关（P〈0．01）。结论VaD患者的执行能力下降，与其脑白质病变程度可能有关。

Objective To explore the correlation between executive function and white matter lesions （WML） and the diagnostic value by clock drawing test（CDT） in patients with vascular dementia （VaD）. Methods Twenty-seven VaD patients and twenty-five normal control subjects were evaluated with CDT to assess the executive function. CDT was scored according the four point method. Age-related white matter change rating scale （ARWMCrs） was used qualitatively to measure and locate the WML by cranial MRI scanning. Results 1. The scores of CDT in normal cognition health and VaD were （3.88 ± 0.33 ） and （ 1.74 ± 0.98 ）. The difference between two groups was statistically significant （P 〈 0.01 ）. The humerous part and the point part were the earliest to decline in the VaD Patients. The scores of WML were（5. 12 ± 4. 19） and （11.19 ± 3.09） , respectively. There was significant difference between two groups （P 〈 0.01 ）. The scores of CDT had significant positive correlation with MMSE scores and negative correlation with WML scores （P 〈 0.01 ）. Conclusion The executive functional impairment in patients with VaD could be associated with the degree of WML.