老年人执行功能障碍与腔隙性脑梗死的关系

Relations between Executive Dysfunction and Lacunar Infarction in Senior Patients

目的探讨老年腔隙性脑梗死患者执行功能损害状况以及二者关系。方法对39例老年志愿者进行头颅MRI、CT检查,按照有无腔隙性脑梗死分为梗死组14例和无梗死组25例,运用神经心理学测试方法评估两组执行功能损害状况,分析腔隙性脑梗死灶的数量和执行功能损害的关系。结果腔隙性梗死组执行功能测验中额叶功能评定量表(FAB)(8.73±3.47)分,执行性画钟作业(CLOX)(8.73±3.47)分,词语流畅性测验(RVR)(29.75±12.17)分,均低于无梗死组的(11.66±2.37)分、(12.15±2.36)分及(38.24±8.93)分(P<0.05)。单因素回归分析显示,腔隙性脑梗死灶的数目和3项执行功能测验均呈明显的负性关系,FAB评分r2=0.9420,P<0.05;CLOX评分r2=0.8715,P<0.05;RVR评分r2=0.9231,P<0.05。结论老年腔隙性脑梗死会对执行功能产生影响,腔隙性脑梗死灶的数量与执行功能的下降显著相关。

Objective To investigate the situation of executive function in patients with lacunar infarction and the relations between the executive dysfunction and lacunar infarctions. Methods 39 senior volunteers were divided into lacunar in- farction group （ n = 14） and non- lacunar infarction group （ n = 25 ） ＂after undergoing head CT and MRI examination. The executive function in the two groups was compared by neuropsychological tests, and the relations between the number of lacunar infarction and the damage of executive function were analyzed. Results The scores of executive function tests in lacunar infarc- tion group were 8.73 ± 3.47 （ frontal assessment battery, FAB）, 8.73 ± 3.47 （ executive clock-drawing task, CLOX） and 29.75 ± 12.17 （vocabulary test, RVR）respectively, but in non-lacunar infarction group they were 11.66 ± 2.37,12.15± 2.36, and 38.24 ± 8.93 respectively,and the differences were significant （P 〈 0. 05 ）. The one-factor regressive analysis showed that the number of lacunar infarction was negatively related to the three executive function tests （ FAB ：r^2 = 0. 9420, P 〈 0. 05 ; CLOX ： r^2 = 0. 8715, P 〈 0. 05 ; RVR ： r^2 = 0. 9231, P 〈 0. 05 ）. Conclusion Lacunar infarction in senior people can affect the executive function. The number of the lacunar infarction is significantly correlated with the： decreasing executive score.