短暂性脑缺血发作和轻度缺血性脑卒中后早期认知障碍特点

Characteristics of early cognitive impairment after transient ischemic attack and mild ischemic stroke

目的应用蒙特利尔认知评估基础量表(MoCA-BC)认知域指数得分(CDIS)分析短暂性脑缺血发作(TIA)和轻度缺血性脑卒中患者早期认知障碍的神经心理特点。方法纳入TIA或急性轻度缺血性脑卒中患者86例,收集临床资料并应用MoCA-BC进行神经心理评估。根据MoCA-BC得分分为认知障碍组和无认知障碍组,并通过CDIS的评分方法计算MoCA-BC CDIS,比较两组患者的临床特点和MoCA-BC CDIS的差异。结果与无认知障碍组相比,认知障碍组患者的年龄较大、受教育年限较短、高血压患者所占比例较高(P<0.05)。认知障碍组的MoCA-BC执行力指数(MoCA-BC EIS)、记忆指数(MoCA-BC MIS)、语言能力指数(MoCA-BC LIS)、视空间能力指数(MoCA-BC VIS)、注意力指数(MoCA-BC AIS)和定向力指数(MoCA-BC OIS)均低于无认知障碍组,差异有统计学意义(P<0.05)。结论TIA和轻度缺血性脑卒中发生后早期认知功能损害涉及多个认知域,尤以执行功能、记忆力受损最为明显。

Objective To investigate the neuropsychological characteristics of early cognitive impairment in patients with transient ischemic attack(TIA)and mild ischemic stroke by using the Montreal Cognitive Assessment-Basic(MoCA-BC)Cognitive Domain Index Score(CDIS).Methods A total of 86 patients with TIA or mild ischemic stroke were enrolled.Clinical data were collected and neurocognitive assessment was performed using MoCA-BC scale.Patients were divided into cognitive impairment group and no cognitive impairment group according to the MoCA-BC score,and the MoCA-BC CDIS were calculated with reference to the CDIS formula published.The clinical characteristics and MoCA-BC CDIS were compared between groups.Results Compared with the no cognitive impairment group,the patients in the cognitive impairment group were older,less educated and had a hypertension(P<0.05).The MoCA-BC Execution Index Score(MoCA-BC EIS),Memory Index Score(MoCA-BC MIS),Language Index Score(MoCA-BC LIS),Visual Spatial Index Score(MoCA-BC VIS),Attention Index Score(MoCA-BC AIS)and Orientation Index Score(MoCA-BC OIS)of the cognitive impairment group were significantly lower than those of the no cognitive impairment group(P<0.05).Conclusion Early cognitive impairment after TIA and mild ischemic stroke involves multiple cognitive domains,especially in the domain of executive and memory.