急性缺血性卒中患者多维认知功能评估研究

Study on Multi-dimensional Cognitive Function Assessment of Acute Ischemic Stroke Patients

目的了解急性缺血性卒中患者多维认知功能特点，为选择全面的、系统的评估工具提供参考根据。方法本研究为横断面研究，连续入组2015年8月～2014年4月第二炮兵总医院神经内科门诊和住院发病14d内的急性缺血性卒中44例，选取年龄、性别、教育水平匹配的无缺血性卒中者44例为对照组。采用简易精神状态检查量表（Mini—Mental statee Examination，MMSE）、中文版蒙特利尔认知评估量表（Montreal congnitive Assessment，MocA）、多维心理评估系统对急性缺血性卒中组和对照组进行认知评估。结果急性缺血性卒中组与对照组在下列测验中差异无显著性：选择反应时测验（27．16±5．02 vs 28．54±5．66；P=0．547）、瑞文推理测验（12．13±5．81 vs 14．91±7．05；P=0．643）、数字序列推理测验（8．68±5．25 vs 11．45±4．76；P=0．287）、词语记忆能力测验（50．98±19．97 vs 56．78±15．89；P=0．516）、言语工作记忆测验（正向）（6．88±1．91 vs 7．23±1．62；P=0．178）、言语工作记忆（反向）（4．51±1．76 vs 5．25±2．13；P=0．922）、语义流畅性测验（11．37±2．65 vs 15．27±1．65；P=0．142）；急性缺血性卒中组在简单计算测验（28．95±15．86 vs 41．26±9．52；P=0．007）、数量大小比较测验（65．75±19．22 vs 79．45±8．62；P=0．008）、空间工作记忆测验（69．65±28．97 vs 85．16±7．25；P=0．004）、图片记忆测验（58．59±18.13 vs 68．64±9．13；P=0．009）、词语辨析测验（20．16±8．22 vs 29．45±5．27；P=0．008）、颜色判断Stroop测验（执行功能）（65．37±22．79 vs 70．85±4．16；P=0．000）上显著低于对照组。结论多维认知功能测查表明急性缺血性卒中患者仅存在局部认知功能受损，能够更详细地反映患者的认知状况。

Objective To study the characteristics of multi-dimensional cognitive function of acute ischemic stroke patient, which can be used as a reference for comprehensive assessment. Methods Eighty eight consecutive patients at Department of Neurology of the Second Artillery General Hospital were prospectively enrolled into this study. The patients were divided into two groups：patients with acute ischemic stroke （44） and control group （44） whose age, gender, education level were well matched. Mini-Mental State Examination （MMSE）, Montreal Congnitive Assessmen （MoCA） and Multi-dimensional Cognitive Function test were used to assess the cognitive function. Results No significant differences are revealed between the acute ischemic stroke group and the reference group in Choice Reaction Time Test （27.16±5.02 vs 28.34±5.66, P=0.347）, Raven Standard Reasoning Test （12.13±5.81 vs 14.91±7.03, P=0.643）, Number Sequence Reasoning Test （8.68±5.23 vs 11.43±4.76, P=0.287）, Word Memory Test （50.98±19.97 vs 56.78±15.89, P=0.316）, Word Working Memory Test （6.88±1.91 vs 7.23±1.62, P=0.178）, Verbal Fluency Test （11.37±2.65 vs 13.27±1.65, P=0.142）. The score between two groups in terms of Simple Computation Test （28.95±15.86 vs 41.26±9.32, P=0.007）, Number Comparison Test （65.75±19.22 vs 79.43±8.62,P=0.008）, Spatial Working Memory Test （69.63＋28.97 vs 83.16±7.23, P=0.004）, Picture Memory Test （58.39±18.13 vs 68.64＋9.13, P=0.009）, Word Discriminating Test （20.16±8.22 vs 29.43±5.27, P=0.008）, Stroop Test （65.37±22.79 vs 70.83±4.16, P=0.000） demonstrated a statistical significance. Conclusion The multi-dimensional cognitive function assessment system reflects that there is local impaired cognitive function in individual cognitive level. It could reflect the cognitive condition of patients in detail.