缺血性卒中责任动脉与认知障碍的相关性研究

Correlation of cognitive impairment with ischemic stroke-inducing cerebral artery

目的 从责任动脉角度探讨缺血性卒中与认知障碍之间的关系,寻找不同责任动脉阻塞所致的特征性认知领域损害及其内在联系以期及早预测认知障碍. 方法 应用蒙特利尔认知评估量表（MoCA）北京版,对250例首次急性发病2周左右的缺血性卒中患者进行认知功能评估,记录其MoCA评分及各单项认知领域评分.按阻塞责任动脉分组,将各组的MoCA认知评估结果进行相关分析. 结果 大脑中动脉供血区梗死与视空间/执行、注意、语言和记忆损害有关（B=-1.875～-1.094,P＜0.05）;大脑前动脉供血区与椎基底动脉供血区梗死与注意损害有关（B=-3.977、-1.833,P＜0.01）;大脑后动脉供血区梗死可导致视空间/执行、语言和记忆损害（B=-1.714～-1.095,P＜0.05）;脉络膜前动脉供血区梗死未发现特征性认知领域损害. 结论 不同责任动脉阻塞所致认知功能损害领域不同,有助于亚急性期脑卒中后认知障碍的预测,建议在亚急性期脑卒中的管理中增加认知障碍评估.

Objective To explore the correlation of cognitive impairment with ischemic strokeinducing cerebral artery,in order to predict and find the correlations between different cognitive dysfunction and different intracranial arterial occlusion.Methods We used Montreal Cognitive Assessment （MoCA） to evaluate neuropsychological statuses in the 250 patients,who developed first time acute myocardial infarction for 2 weeks.MoCA scores and other neuropsychological cognitive assessment scores were recorded.Patients were grouped by the location of intracranial arterial occlusion.The neuropsychological cognitive assessment results were analyzed between groups.Results Middle cerebral artery occlusion was correlated with impairments of visual spatial/executive,attention,language and memory （B=-1.875 ～-1.094,P＜0.05）.Anterior cerebral artery and vertebral basilar artery occlusion had correlations with attention impairment （B =-3.977,B =-1.833,P＜0.01）.Posterior cerebral artery occlusion could cause visual spatial/executive,language and memory impairment（B=-1.714 ～-1.095,P＜0.05）.No correlation of cognitive impairment characteristics with anterior choroidal artery occlusion was found.Conclusions Different arterial occlusion can cause different characteristics of impairment in cognitive function,which can help to predict cognitive impairment after sub-acute stroke.It suggests that some cognitive assessments must be conducted in sub-acute stroke management.