老年类风湿关节炎病人脑白质疏松及认知功能改变的研究

Relationship between leukoaraiosis and cognitive function changes in elderly patients with rheumatoid arthritis

目的观察老年类风湿关节炎病人的脑白质疏松程度及认知功能的变化。方法收集我院2015年7月至2017年7月确诊类风湿关节炎的老年病人96例作为观察组,同时选取38例内科住院病人作为对照组,2组均完善头颅CT检查并完成简易智力状况检查(Mini-Mental State Examination,MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评分,评估2组脑白质疏松程度及认知功能改变情况,分析脑白质疏松严重程度与认知功能改变关系。结果观察组出现脑白质疏松比例明显高于对照组,MMSE和MoCA评分明显低于对照组,差异有统计学意义(P<0. 05);脑白质疏松越严重者认知功能损害越明显(P<0. 05)。结论老年类风湿关节炎与脑白质疏松的发生密切相关且可导致认知功能下降。

Objective To observe the leukoaraiosis（ LA） and the changes of cognitive function in the elderly patients with rheumatoid arthritis（ RA）. Methods A total of 96 cases of elderly patients with RA diagnosed in our hospital from July 2015 to July 2017 were selected as the observation group,and 38 elderly inpatients were selected as the control group. The head CT was performed and the scores of Mini-Mental State Examination（ MMSE） and Montreal Cognitive Assessment（ MoCA） were evaluated in two groups. The degree of LA and the change of cognitive function in the two groups were observed,and the relationship between the severity of LA and the change of cognitive function in the elderly patients with RA was further analyzed. Results The incidence rate of LA was significantly higher and the scores of the MMSE and MoCA were significantly lower in observation group than those in control group（ P〈0. 05）. The patients showed severe LA with the more obvious impairment of cognitive function（ P〈0. 05）. Conclusions RA is closely related to the occurrence of LA in the elderly patients,and may play an important role in cognitive impairment.