脑白质疏松轻度认知障碍患者认知损害特点分析

Characteristic Anylisis of Cognitive Impairment of Mild Cognitive Impairment Patients with Leukoaraiosis

目的探讨脑白质疏松轻度认知障碍(leukoaraiosis mild cognitive impairmen,LACI)的认知损害特点,为临床诊治提供参考。方法纳入LACI组77例及脑白质疏松(leukoaraiosis,LA)且无认知障碍组(对照组)74例进行蒙特利尔认知评估(Montreal cognitive assessment,MoCA)量表等心理量表检测。结果 LACI组MoCA量表总分为20.84±3.04分,对照组27.38±1.25分,差异有统计学意义(P<0.01);LACI组在MoCA量表的亚项-视空间与执行、命名能力、注意力、语言能力、抽象能力、延迟记忆能力、定向力等7个认知域的得分均较对照组低(P<0.01),MoCA总分与各亚项得分进行相关分析,除命名及语言能力2个亚项外,其他5个亚项均与总分有正相关关系,按相关系数的高低排序,依次为视空间与执行功能、延迟记忆、注意力、抽象能力、定向力。结论 LACI患者在视空间与执行、命名能力、注意力、语言能力、抽象能力、延迟记忆能力、定向力等认知域有不同程度的损害,其中视空间与执行功能、延迟记忆、注意力、抽象能力、定向力损害可能是早期损害较为明显的认知域,且在记忆过程中的编码、存储、提取这3个关键环节可能都存在损害。

Objective To explore mild cognitive impairment with impairment characteristics of leukoaraiosis（LACI）, and to provide the reference for clinical diagnosis and treatment. Methods Seventy-seven patients with LACI and 74 leukoaraiosis（LA） patients without cognitive impairment（control group） were tested by Montreal cognitive assessment（MoCA） scale and other psychological scales. Results The total score of MoCA（20.84±3.04） in LACI group was lower than that in the control group（27.38 ± 1.25）（P〈 0.01）.There was significant difference between the two groups in the space and execution, depending on-named ability, attentions language ability, abstract ability, delayed memory ability and directional power of seven cognitive domains（P〈0.01）. The correlation analysis between the total score of the MoCA scores and secondary types showed that except for the naming and language ability, there was a positive correlation between the other five secondary types and the total scores, according to high-and-low ranking in the correlation coefficient, which in turn depends on the space and executive function for delay, memory, attention, abstract ability, directional power. Conclusion LACI patients have different damage levels on visual space, execution, named ability, attention, language ability, abstract ability, delayed memory ability, directional power and some other cognitive domains, and visual space and executive function, delayed memory, attention, abstract, directional power ability may be obvious cognitive domains in the earlier damage, the three key link in the process of memory such as encoding, storage, extraction have existed in the damage.