无症状脑梗死与认知功能障碍临床诊疗进展

Clinical Diagnosis and Treatment of Silent Brain Infarction and Cognitive Impairment

中老年人群中无症状脑梗死(silent brain infarction,SBI)检出率越来越高,SBI可导致认知功能障碍。本文通过系统回顾国内外有关SBI和认知功能障碍关系的相关文献,分别从流行病学、发病机制、评估、诊断、治疗方面对国内外文献进行分析整理,最终得出SBI中认知障碍的发生率约50%,其发病机制与脑血流量、病灶部位、数量及是否合并危险因素等相关,评估主要采用简易精神状态量表(mini-mental state examination,MMSE)和中文版蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)表相结合,治疗方面缺乏针对性研究,主要参考血管性认知功能障碍进行。总的来说,SBI所致认知功能障碍研究较少,尤其缺乏较高质量研究。

The detection rate of silent brain infarction(SBI)is increasing in middle-aged and elderly people.SBI can lead to cognitive impairment.This paper reviewed the related literatures about the relationship between SBI and cognitive impairment at home and abroad,and analysed the literatures from epidemiology,pathogenesis,evaluation,diagnosis and treatment.It was concluded that the incidence of cognitive impairment in SBI was about 50%,and its pathogenesis was related to cerebral blood flow,lesion location,number and whether or not.Combined with risk factors,the assessment was mainly based on the mini-mental state examination(MMSE)and the Chinese version of the Montreal cognitive assessment(MoCA)table.There was a lack of targeted research in the treatment,mainly referring to vascular cognitive impairment.Generally speaking,the cognitive impairment caused by SBI is studied few,especially the lack of high-quality research.