脑梗死后认知功能障碍临床特点分析

Study of the clinical characteristics on cognitive function impairment after cerebral infarction

目的对脑梗死后血管性认知功能障碍临床特点进行探讨。方法连续选取急性脑梗死患者149例,通过CT或MRI明确其病灶部位,并于发病后3个月采用MoCA、CDR和ADL评价患者的认知功能和日常生活活动能力,根据MoCA和CDR标准将其分为无血管性认知功能障碍(N-VCI)组﹑血管性认知功能障碍无痴呆(CIND)组﹑血管性痴呆(VD)组。结果①脑梗死后认知功能损害越重,日常生活能力越低;②VD组与CIND组﹑N-VCI组比较,视空间与执行﹑记忆﹑注意﹑语言及定向力有明显差异,CIND组与N-VCI组比较,视空间与执行﹑语言有明显差异;③VCI组额叶﹑颞叶﹑基底节区﹑丘脑梗死明显多于N-VCI组(P<0.01)。结论脑梗死后VCI的发生率高,注意力和执行功能﹑短时记忆和语言能力受损为其主要表现;额叶﹑颞叶、丘脑和基底节区的梗死易引起VCI的发生。

Objective To investigate the Clinical Characteristics on cognitive function impairment after cerebral infarction. Methods Selected 149 cases of acute stroke patients, whowere hospitalized in neurological department of the First Peo- ple＇s Hospital of Zhumadian, definited the sites of the infarction by CT or MRI. Evaluated cognition and daily life activities by MoCA,CDR and ADL scale after 3 months,According to the MoCA and CDR standards,were assigned to N-VCI group, VCIND group and VD group. Then, studied the clinical characteristics of VCI. Results （2）After cerebral infarction cognitive impairment was heavier, the lower the daily activities（P 〈 0.01）;（3）Compared with VCIND and N-VCI group,the scores of view space and executive capability, memory, attention, languages and orientation in VD group were significant- ly lower,there were siguificantly statistical differences （P 〈 0.01）, compared with N-VCI group,the scores of view space and executive capability, languages in VCIND group were significantly lower, there were significantly statistical differences （P 〈 0.01）; （3）There were significantly statistical difference between VCI group and N-VCI group in frontal lobe, temporal lobe, hemorrhage of basal ganglion area and thalamencephalon （p 〈 0.05）. Conclusion Cognitive function impairment is a common complication of cerebral infarction patients, and the main dysfunction were executive function, attention, shortterm memory and languages;Infarction of frontal lobe, temporal lobe, hemorrhage of basal ganglion area and thalamencephalon significantly cause VCI.