脑出血后白质微观结构损伤与血管性认知功能障碍的相关性研究

Correlation of White Matter Microstructure Damage with the Vascular Cognitive Dysfunction after Intracerebral Hemorrhage

目的:探讨脑出血后白质微观结构损伤情况和血管性认知功能功能障碍(VCI)的相关性。方法:选择2012年1月至2017年12月我院收治的脑出血患者50例作为研究对象,所有患者按照神经心理学评估结果分为认知功能障碍组(A组)29例和认知正常组(B组)21例,观察和比较两组患者病灶情况和白质微观结构的改变情况。结果:A组患者额区、基底核区病灶数量,病灶直径、白质病变、美国国立卫生院卒中量表(NIHSS)_评分等指标均明显高于B组,改良巴氏指数(MBI)评分低于B组(P<0.05);将蒙特利尔认知评估(MoCA)量表评分作为因变量,MBI评分和NIHSS量表评分、病灶直径、病灶数量、白质病变程度等作为自变量进行多元Logistic回归分析,结果显示白质病变程度是脑出血患者VCI独立危险因素(P<0.05)。结论:脑出血患者白质缺血性病变程度可能用于评估其发生VCI的风险。

Objective: To investigate the correlation of white matter microstructure damage with the vascular cognitive dysfunction in patients with intracerebral hemorrhage. Methods: 50 cases of patients with cerebral hemorrhage admitted in our hospital from January 2012 to December 2017 were studied. All patients were divided into 29 cases of cognitive dysfunction group(group A) and 21 cases of normal cognitive group(group B) according to the neuropsychology results. The lesions and the changes of white matter gastric tube structure were observed and compared between two groups. Results: The number of lesions in the frontal area and basilar nucleus, the lesion diameter and white matter lesions, national institutes of health stroke scale(NIHSS) of group A were significantly higher than those of the group B. The score of modified barthrel index(MBI) was lower than that of the group B(P<0.05). The montreal cognitive assessment(MoCA) scale score was used as the dependent variable, the MBI score and the NIHSS scale score, the lesion diameter, and the degree of white matter lesions were analyzed by multiple Logistic regression as independent variables. The results showed that the degree of white matter was an independent risk factor for VCI in patients with cerebral hemorrhage(P<0.05). Conclusion: The degree of white matter ischemic lesions may be used to evaluate the risk of VCI in patients with cerebral hemorrhage.