脑小血管病引发的脑白质疏松与认知功能障碍的相关性研究

Research on the correlation between leukoaraiosis caused by cerebral small vessel disease and cognitive impairment

目的分析脑小血管病引发的脑白质疏松与认知功能障碍的相关性。方法选取脑小血管病伴脑白质疏松患者60例为研究组,另选取无神经系统疾病和精神疾病的60例健康人为对照组,研究组患者进行脑颅MR扫描,根据白质变化分级量表分为Ⅰ度(轻度)亚组20例、Ⅱ度(中度)亚组20例及Ⅲ度(重度)亚组20例,根据简明精神状态量表及蒙特利尔认知量表对认知功能进行评估,探讨脑白质疏松与认知功能障碍的关系。结果脑白质疏松的影响因素有年龄及微出血史(P<0.05),与受教育时间、高血压史、糖尿病史及高血脂无明显关系(P>0.05);经简明精神状态量表评分,Ⅰ度亚组患者评分(20.5±4.1)与对照组比较(22.5±4.5)无显著差异(t=1.395,P>0.05);Ⅱ度亚组和Ⅲ度亚组分别为16.5±3.5、16.0±3.3,明显低于对照组的22.5±4.5(P<0.05);经蒙特利尔认知量表明细评分,研究组视空间与执行能力、注意力、语言能力、抽象能力、命名能力、延迟记忆和定向力评分低于对照组(P<0.05)。结论脑小血管病引发的脑质疏松与认知功能障碍有重要联系,可通过脑白质疏松情况对患者进行认知障碍的早期检查。

Objective To analyze the correlation between leukoaraiosis caused by cerebral small vessel disease and cognitive impairment.Methods Sixty patients with cerebral small vessel disease complicated with leukoaraiosis in our hospital from October2015 to October 2016 were enrolled as research group;another 60 cases of healthy medical staff without neurological and psychiatric disorders were enrolled as control group.Patients in research group received brain MR scan and divided into Ⅰ degree(mild)subgroup of 20 cases,Ⅱ degree(moderate)subgroup of 20 cases and Ⅲ degree(severe)subgroup of 20 cases according to the leukoaraiosis grading scale.The cognitive function was evaluated by concise mental state scale and Montreal cognitive scale,the correlation between leukoaraiosis and cognitive impairment was analyzed.Results The influential factors of leukoaraiosis were age and microbleeds(P<0.05),but there was no significant difference between the education time,the history of hypertension,diabetes mellitus and hyperlipidemia(P>0.05).The concise mental state scale scores showed that,the score of the patients in the subgroup was 20.5±4.1,which was not significantly different from 22.5±4.5of the control group(t=1.395,P>0.05).The scores of the patients with subgroup Ⅱ andⅢ were 16.5±3.5and 16.0±3.3,respectively,which were significantly lower than 22.5±4.5of the control group(P<0.05).The detailed score of the Montreal cognitive scale showed that,the visual spatial and executive abilities,attention,linguistic competence,abstraction ability,naming ability,delayed memory and orientation score were significantly lower in the study group than in the control group(P<0.05).Conclusion Leukoaraiosis caused by cerebral small vessel disease is closely correlated with cognitive impairment.We can take early examination of cognitive impairment according to the patients leukoaraiosis.