脑白质疏松患者的皮质下特征及其对认知功能和日常生活能力的影响

Effect of subcortical features on cognitive function and activities of daily living in patients with leukoaraiosis

目的探讨脑白质疏松(LA)患者的皮质下特征及其对认知功能和日常生活能力的影响。方法选择100例LA患者作为研究对象,采用简易智能精神状态检查量表(MMSE)、剑桥老年认知量表中文版(CAMCOG-C)、画钟试验(CDT)、老年抑郁量表(GDS)、日常生活能力量表(ADL)、计时"起立—行走"测试(TUG)等对认知功能、抑郁、日常生活能力以及皮质下特征等进行评定。结果 LA患者伴随皮质下特征以排尿障碍最为常见(66%),其次为假性球麻痹(55%)、抑郁症状(47%)。LA患者伴皮质下特征组与相应的无皮质下特征组比较,均伴随着CAMCOG-C评分下降和ADL评分升高(P<0.05),提示LA伴随皮质下特征与LA认知损害及日常生活能力下降有关。结论 LA患者的皮质下特征较为常见,可严重影响认知功能和日常生活能力。

Objective To investigate the effect of subcortical features on cognitive function and activities of daily living in patients with magnetic resonance imaging（MRI）-defined leukoaraiosis（LA）.Methods The cohort for this study included 100 LA patients.Cognitive functions were measured by the mini-mental state examination（MMSE）,the Cambridge cognitive examination-Chinese version（CAMCOG-C）,activity of daily living（ADL） and clock drawing task（CDT） etc.Depression symptoms were assessed by the geriatric depression scale（GDS） while subcortical features by the timed up and go test etc.Results The highest prevalence of subcortical feature was urinary dysfunction（66%） in patients with LA,secondly pseudobulbar palsy（55%） and depression（37%）.There were statistical differences between all the subcortical features and cognitive functions,activities of daily living scale（ADL）.The patients with subcortical features had lower performances on CAMCOG-C and higher ADL scores（P 0.05）.Among the subcortical features,patients with clinical signs such as gait dysfunction,unprovoked falls and pseudobulbar palsy had poor executive function（P 0.05）.Conclusion The subcortical features in patients with LA are common and may influence cognition function and activities of daily living.