脑微出血危险因素及其与认知功能的相关性研究

Risk Factors of Cerebral Microbleeds and Its Correlation with Cognitive Impairment

目的探讨脑微出血(cerebral microbleeds,CMBs)患者认知功能损害的临床特征及其相关因素。方法研究对象来自2016年6月-2017年12月就诊于首都医科大学附属北京同仁医院的30例CMBs患者和30例年龄、性别、受教育程度相匹配的对照组,采用简易智力状态量表(mini-mental state examination,MMSE)和蒙特利尔认知量表(Montreal cognitive assessment,MoCA)评价认知功能。采用Fazekas量表评价脑白质病变的严重程度。CMBs组采用微出血解剖评分量表(microbleed anatomical rating scale,MARS)评估CMBs严重程度。分析CMBs严重程度与脑白质病变严重程度及认知障碍的相关性。结果 CMBs组MMSE([24.9±2.7)分vs(28.0±1.8)分,P=0.002]和MOCA([23.6±3.4)分vs(26.2±3.0)分,P=0.003]评分均显著低于对照组;脑白质病变的严重程度(Fazekas评分)与CMBs的严重程度呈正相关(r=0.431,P=0.03);MOCA评分与CMBs的严重程度呈负相关(r=-0.52,P=0.02)。结论 CMBs患者存在明显的认知功能障碍,MOCA评分与脑微出血的严重程度负相关;脑白质病变程度与CMBs的严重程度正相关。

Objective To examine the clinical characteristics and correlative factors of cognitive dysfunction in patients with cerebral microbleeds（CMBs）.Methods A total of 30 patients with SVD and 30 age, sex and education-matched control subjects were recruited consecutively from department of neurology, Beijing Tongren hospital. The cognitive function of all participants were evaluated by neuropsychological tests, including mini-mental state examination（MMSE）, Montreal cognitive assessment（MoCA）. The severity of white matter lesions was evaluated by the Fazekas scale, and the severity of CMBs by the microbleed anatomical rating scale（MARS）. The correlation between the severity of CMBs and white matter lesions/cognitive function were analyzed.Results We found that CMBs was related to global cognitive function deficits. The severity of CMBs was positively related to the severity of white matter lesions（r=0.431, P=0.03）. The severity of CMBs was negatively related to the score of MoC A（r=-0.52, P=0.02）.Conclusion CMBs was closely related to cognitive impairment. The severity of CMBs was negatively related to the score of MoCA, and the severity of CMBs was positively related to the severity of white matter lesions.