腔隙性脑梗死、脑白质病变与认知功能、情感障碍的相关性

Correlation between lacunar infarction,white matter lesions and cognitive function and affective disorder

目的:探讨腔隙性脑梗死(LI)、脑白质病变(WML)与认知功能、情感障碍的相关性。方法:将35例LI患者纳入LI组,35例WML纳入WML组,30例LI合并WML纳入LI合并WML组(上述3组为观察组),将30例非脑血管疾病患者纳入对照组。评估各组患者日常生活能力(ADL量表)、认知功能(MoCA、MMSE量表)、抑郁及焦虑情绪(HAMA、HAMD量表)。结果:观察组各亚组患者HAMD、HAMA评分及ADL评分均高于对照组,MoCA、MMSE评分均低于对照组;LI合并WML组患者ADL、HAMD、HAMA评分均高于LI组及WML组,MoCA、MMSE评分均低于LI组及WML组(P<0.05)。LI合并WML组发生认知功能障碍率、情感障碍率及认知功能并情感障碍率均明显高于LI组和WML组(P<0.05)。相关性分析显示LI、WML病变程度均与患者情感障碍程度呈正相关,与患者认知功能呈负相关(P<0.05);观察组患者认知功能越低,情感障碍越严重,但无相关性(P>0.05)。结论:LI、WML患者病变程度与患者认知功能、情感状况密切相关,病情越严重,患者认知能力越差,情感障碍越严重,但此类患者认知功能与情感障碍之间无明显相关性。

Fund project Science and technology research and development guidance plan of Cangzhou City（number：172302135） Abstract Objective：To explore the correlation between lacunar infarction（LI）,white matter lesions（WML） and cognitive function and affective disorder.Methods：35 patients with LI were included in the LI group,35 patients with WML were included in the WML group,30 cases with LI and WML were included in the LI complicated with WML group（The above 3 groups were the observation group）,30 patients with non cerebral vascular diseases were included in the control group,we assessed the activities of daily living（ADL scale）,cognitive function（MoCA,MMSE scale）,depression and anxiety（HAMA,HAMD scale） in each group.Results：The HAMD,HAMA scores and ADL scores of the observation group were higher than those of the control group,while the scores of MoCA and MMSE were lower than those of the control group.In the LI complicated with WML group,the scores of ADL,HAMD and HAMA were all higher than those of the LI group and the WML group,and the scores of MoCA and MMSE were lower than those of the LI group and the WML group（P〈0.05）.In the LI complicated with WML group,the incidence of cognitive impairment,the incidence of affective disorders and the incidence of cognitive dysfunction combined with affective disorder weresignificantly higher than those in the LI group and the WML group（P〈0.05）.Correlation analysis showed that the degree of LI and WML lesions were positively correlated with the degree of affective disorder,and negatively correlated with the cognitive function of patients（P〈0.05）.In the observation group,the lower the cognitive function,the more serious the affective disorder,but there was no correlation（P〉0.05）.Conclusion：The degree of lesion in LI and WML patients was closely related to cognitive function and emotional state.The more serious the disease was,the poorer the patient＇s cognitive ability was and the more serious the affective disorder was,however,there was no significant correlation between cognitive function and affective disorders.