脑小血管闭塞患者认知功能变化的临床研究

Cerebral small artery occlusion,SAO and cognitive function

目的探讨脑小血管闭塞(SAO)患者认知功能障碍的特点。方法临床收集110例患者和50例正常对照人群,根据MRI T2加权像和FLAIR像将病例组分为单纯性腔隙性脑梗死(ILI)组和缺血性白质疏松(ILA)组,分别进行简明精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)。结果①与对照组比较,ILI组和ILA组患者的MMSE和MoCA评分均明显低(P<0.05);②与对照组比较,ILI组患者注意计算、短程记忆、图形描画评分显著降低(P<0.05);ILA组患者时间定向、注意计算、短程记忆、语言理解和图形描画评分显著降低(P<0.05)。结论①脑小血管病变,可导致认知功能下降,ILA时最为显著;②ILA组患者主要表现为执行功能、视空间功能、注意计算、短程记忆等认知方面的障碍。

Objective To investigate the change of cognitive function in the patients with small artery occlusion （ SAO） .Methods 110 patients were classified into group with isolated lacunar infarction （ ILI） , and group with ischaemic leukoaraiosis （ILA） according to MRI T2 images and FLAIR images.50normal persons as control group.All subjects＇cognitive status were assessed with mini-mental state examination （ MMSE ） and Montreal Congnitive Assessment （ MoCA ） .Results The scores of MMSE and MoCA in the patients with SVD were significantly less than that in the control group （P〈0.05）; Compared with the control group, account ability,short term memory and graphics portrayed score decreased significantly in ILI group （ P〈0.05）; time orientation, account ability, short term memory , language understanding and graphics portrayed score decreased significantly in ILA group （P〈0.05）.Conclusion Cerebral small artery occlusion leads to cognitive decline especially in patients with ILA;cognitive declines such as executive function , visual-spatial function , account ability , short term memory are more popular .