不同梗死部位的急性脑梗死患者血管性认知障碍的特点分析

The Characters of the Vascular Cognitive Impairment in Patients with Acute Cerebral Infarction at Different Locations

目的观察不同梗死部位的急性脑梗死患者血管性认知障碍的特点。方法选取2015年1—10月安阳市人民医院神经内科收治的急性脑梗死患者200例,患者均进行颅脑MRI检查,分別记录梗死部位(包括额叶、颞叶、顶叶、枕叶、脑干、小脑、丘脑、侧脑室、基底核区、胼胝体等),并采用MoCA量表评价所有患者的认知功能。分析不同梗死部位引起认知障碍的特点。结果梗死部位为额叶、颞叶、丘脑、基底核区、胼胝体的急性脑梗死患者认知障碍的发生率分别是64.7%、73.3%,61.0%、58.3%、71.4%,而认知功能正常的发生率为32.6%、26.7%、10.0%、41.7%、28.6%。梗死部位为颞叶的急性脑梗死患者视空间/执行功能受损情况与认知功能正常患者比较,差异有统计学差异(P<0.05);梗死部位为额叶的急性脑梗死患者命名功能受损情况与认知功能正常患者比较,差异有统计学差异(P<0.05);梗死部位为颞叶、丘脑、基底核区、胼胝体的急性脑梗死患者记忆/回忆功能受损情况与认知功能正常患者比较,差异有统计学差异(P<0.05);梗死部位为额叶、颞叶的急性脑梗死患者注意/计算受损情况与认知功能正常患者比较,差异有统计学差异(P<0.05);梗死部位为额叶的急性脑梗死患者语言功能受损情况与认知功能正常患者比较,差异有统计学差异(P<0.05);梗死部位为额叶、颞叶的急性脑梗死患者抽象功能受损情况与认知功能正常患者比较,差异有统计学差异(P<0.05);梗死部位为额叶、颞叶、丘脑、基底核区、胼胝体的急性脑梗死患者定向功能受损情况与认知功能正常患者比较,差异无统计学差异(P>0.05)。结论在额叶、颞叶、丘脑、基底核区、胼胝体处发生梗死的急性脑梗死患者易发生认知障碍。

Objective To observe the characters of the vascular cognitive imparment in patients with acute cerebral infarction at different locations. Methods 200 patients with acute cerebral infarction admitted to the People＇s Hospital of Anyang City from January to October in 2015 were selected. All patients underwent head MRI examination, and infarct locations were recorded. MoCA scale was used to evaluate the cognitive function of all patients. To observe the characters of the vascular cognitive imparment in patients with acute cerebral infarction at different locations. Results Incidence of cognitive impairment was 64. 7% , 73. 3%,61.0%,58. 3%,71. 4% in infarct of acute cerebral infarction patients in frontal lobe, temporal lobe, thalamus, basal ganglia, corpus callosum, and normal incidence of cognitive function was 32. 6 % , 26. 1 % , 10 . 0 %, 41. 7% , 28. 6% in the same patients. There was significant difference in visual spatial / executive function impairment between patients with acute cerebral infarction at temporal lobe infarction and normal cognitive function （ P 〈 0. 05） ; There was significant difference in the naming function impairment between patients with acute cerebral infarction at frontal lobe and normal cognitive function （ P 〈 0. 05 ） ; There was significant difference in the memory / recall function between patients with acute cerebral infarction at temporal lobe, thalamus, basal ganglia and normal cognitive function （ P 〈0. 05） ; There was significant difference in the attention / calculation damage function between patients with acute cerebral infarction at frontal lobe, temporal lobe and normal cognitive function （ P 〈 0. 05） ; There was significant difference in the language impairment between patients with acute cerebral infarction at frontal lobe infarction and normal cognitive function （ P 〈 0. 05 ） ; There was significant difference in the impairment of abstract function between patients with acute cerebral infarction at frontal lobe and temporal lobe infarction and normal cognitive function （P 〈 0. 05 ） ; There was no significant difference in the patients with acute cerebral infarction at the frontal lobe, the temporal lobe, the thalamus, the basal ganglia, the corpus callosum, and normal cognitive function （ P 〉0 . 05 ）. Conclusion Patients with acute cerebral infarction at frontal lobe, temporal lobe, thalamus, basal ganglia and corpus callosum are easy to happen cognitive impairment.