脑出血病人血管性认知功能障碍与白质缺血性病变的相关性研究

Correlation between vascular cognitive impairment and white matter ischemic lesion in encephalorrhagia patients

目的:探讨脑出血病人血管性认知功能障碍(VCI)与白质缺血性病变的相关关系。方法:选取脑出血病人136例,按照神经心理学评估结果分为认知损害组和认知正常组。其中认知损害组69例,存在VCI,认知正常组67例,无认知损害。比较2组不同区域病灶数量、病灶直径、白质病变程度及美国国立卫生研究院卒中量表(NIHSS)评分、改良Barthel指数评定量表(MBI)评分。采用多元logistic回归分析分析认知功能障碍程度与上述指标的相关关系。结果:2组幕下区、顶枕区和颞区的病灶数目差异均无统计学意义(P>0.05),与认知正常组比较认知损害组的NIHSS评分较高(P<0.01),白质病变程度、基底核区与额区的病灶直径较大、病灶数目较多(P<0.01),改良MBI评分较低(P<0.01)。多元logistic回归分析显示白质病变程度与认知功能障碍程度呈正相关关系(P<0.05)。结论:VCI程度可以通过脑出血病人白质缺血性病变程度进行有效评估。

Objective：To investigate the correlation between vascular cognitive impairment （VCI） and the white matter ischemic lesion in encephalorrhagia patients. Methods： One hundred and thirty-six patients with encephalorrhagia were divided into the congnitive impairment group（69 cases with vascular cognitive impairment） and normal cognition group （67 cases without cognitive impairment）. The lesion number, lesion diameter, white matter lesion severity, NIHSS score and modified Barthel index score of different lesion locations between two groups were compared. The correlations between the vascular cognitive impairment degree and related indictors were analyzed using the logistic regression analysis. Results：The differences of the lesion number in temporal, parieto-occipital and infratentorial area between two groups were not statistically significant （ P 〉 0. 05 ）. Compared with the patients without cognitive impairment, the NIHSS score,the white matter lesion severity and number and diameter of lesion in basal ganglia and frontal area, and the modified Bathel index score were higher, larger and lower in patients with cognitive impairment, respectively （P 〈 0.01 ）. Logistic regression analysis showed that the white matter lesion severity was positive correlation with the degree of cognitive impairment （ P 〈 0.05）. Conclusions： The degree of vascular cognitive impairment in encephalorrhagia patients can be effectively assessed by the severity of white matter ischemic lesion.