老年人认知功能障碍与缺血性脑白质病变的相关性分析

Correlation analysis of cognitive dysfunction and ischemic leukodystrophy in elderly patients

目的 研究老年人认知功能障碍与缺血性脑白质病变的相关性.方法 选取2016年3月至2017年10月平煤神马医疗集团总医院收治的老年缺血性脑白质病变患者88例设为研究组,另取同期于本院进行体检的健康老年人30例,设为对照组.记录并比较两组MoCA量表各项评分,分析研究组患者病情严重程度与MoCA量表各项评分的关系.将研究组患者按照是否发生认知功能障碍分为认知功能障碍组（54例）与无认知功能障碍组（34例）,比较两亚组患者各项基本资料,并纳入多因素Logisitic回归分析.结果 研究组总分、视空间与执行、注意、计算、语言、延迟回忆、定向功能评分均低于对照组,差异有统计学意义（P〈0.05）.轻度组、中度组、重度组患者总分、延迟回忆、定向功能评分均呈逐渐降低趋势,组间比较差异有统计学意义（P〈0.05）.认知功能障碍组年龄、高血压人数占比、糖尿病人数占比均高于无认知功能障碍组,差异有统计学意义（P〈0.05）.多因素Logisitic回归分析显示,缺血性脑白质病变老年患者认知功能障碍的独立危险因素包括年龄、高血压、糖尿病（P均〈0.05）.结论 老年人认知功能障碍与缺血性脑白质病变密切相关,且随着缺血性脑白质病变严重程度的增加,患者认知功能障碍越明显.

Objective To study and analyze the correlation between cognitive dysfunction and ischemic leukodystrophy in elderly patients .Methods Eighty-eight elderly patients with ischemic leukodystrophy hospitalized in Pingmei Shenma Medical Group General Hospital from March 2016 to October 2017 were selected as research group .In addition , 30 healthy elderly patients who underwent physical examination in the same hospital were selscted as control group .The scores of the Montreal cognitive assessment （ MoCA ） of the two groups were analyzed and compared , and the relationship between the severity of disease and scores of MoCA scale was analyzed .Patients in research group were divided into cognitive dysfunction group （ 54 cases ） and non-cognitive dysfunction group （ 34 cases ） , according to cognitive dysfunction development , for comparison on the basic data by multivariate Logistic regression analysis .Results The total score , visual space and executive function , attention , calculation , language , delayed recall and directional score of research group were lower than those of control group , and the differences were statistically significant （ all P 〈0.05）.The total score, delayed recall, directional score all showed a trend of gradually reduction in mild group , moderate group and medium group, contrast differences between groups were statistically significant （ all P〈0.05 ） .The age, proportion of hypertension and diabetes in cognitive dysfunction group was higher than those in non -cognitive impairment group , and the difference was statistically significant （ all P〈0.05 ） .Multivariate logistic regression analysis revealed that age , hypertension and diabetes were the independent risk factors of cognitive dysfunction in elderly patients with ischemic leukodystrophy （ all P 〈0.05 ） .＆nbsp;Conclusions Cognitive dysfunction in the elderly is closely related to ischemic leukodystrophy , and with the increase of the severity of ischemic leukodystrophy , the more obvious the cognitive dysfunction is .