老年腔隙性脑梗死患者轻度血管性认知功能障碍的分析

Mild vascular cognitive impairment in aged patients with lacunar cerebral infarction

目的探讨老年腔隙性脑梗死患者轻度血管性认知功能障碍的发生率及不同病变部位对各认知域的影响。方法用蒙特利尔认知评估量表对120例腔隙性脑梗死患者(腔梗组)和84例非脑卒中患者(对照组)进行认知功能评价。结果腔梗组轻度认知功能障碍发生率为45.83%,对照组为26.19%,2组差异有统计学意义(P<0.05)。与对照组比较,腔梗组患者蒙特利尔认知评估量表总分评分、视空间与执行能力、命名能力、注意力、计算力、语言功能、抽象能力、延迟回忆、定向能力评分明显降低,差异有统计学意义(P<0.01);额叶深部、基底节区、颞叶评分明显降低,差异有统计学意义(P<0.01)。结论老年人腔隙性脑梗死轻度血管性认知功能障碍发生率高,对各认知域功能均有影响,但对空间及执行能力、记忆力、语言能力影响更明显,执行功能障碍是老年人腔隙性脑梗死认知损害的显著特点。

Objectlve To study the incidence of mild vascular cognitive impairment（MVCI） in aged patients with lacunar infarction（LI） and the effect of MVCI at different locations on cognitive do- mains. Methods One hundred and twenty aged patients with LI enrolled in this study and 84 pa- tients without stroke served as LI group and control group,respectively. Their cognitive function was assessed with Montreal Cognitive Assessment（MoCA）. Results The incidence of MVCI was higher in LI group than in control group（45.83% vs 26.19% ,P〈0.05）. The total score of MoCA and the scores of visual space, executive function, nomenclature, attention power, calculation ability,linguistic function, abstractive ability, delayed recall, and orientation force were lower in LI group than in control group（P〈0.01）. Conclusion The incidence of MVCI is high in aged patients with LI. MVCI exerts its effect on different cognitive domains,especially on space and executive capacity, memory and linguistic function. Executive dysfunction is the significant feature of aged patients with LI.