TOAST分型不同亚型急性脑梗死认知障碍的分析

Analysis of Cognitive Impairment in Different Subtypes of TOAST Classification of Acute Cerebral Infarction

目的:分析脑梗死TOAST分型大动脉粥样硬化(LAA)和小动脉闭塞(SAO)患者的认知功能.方法:收集LAA型42例及SAO型66例为病例组;45例体检者为对照组.对两组应用MMSE和MoCA量表评价认知功能,记录评分;扩大的血管周围间隙(EPVS)评分.采用统计学软件进行数据处理.结果:(1)MoCA量表筛查SAO型认知障碍发生率65.2%,高于LAA亚型54.8%,有统计学意义(P<0.05)(.2)EPVS评分SAO亚型分别高于LAA亚型、对照组,差异显著(P<0.05)(.3)LAA、SAO认知域损害有不同,两组在视空间与执行能力、注意力方面比较差异显著(P<0.05).结论:急性脑梗死LAA、SAO两亚型早期即有认知障碍发生,且认知损害域有差异;EPVS与血管性认知障碍可能相关.

Objective:To analyze the patients’cognitive function of large artery atherosclerosis(LAA)and small artery occlusion(SAO)cerebral infarction of TOAST classification.Methods:Collected 42 cases of LAA subtype and 66 cases of SAO subtype as the case group;45 cases of physical examination as the control group.The MMSE and MoCA scales were applied to the two groups to evaluate cognitive function and recorded the score;and the expanded perivascular space(EPVS)was also used to score.The data were processed by statistical software.Results:(1)The incidence of SAO subtype cognitive impairment in MoCA scale screening was 65.2%,which was higher than that of LAA subtype(54.8%),and was statistically significant(P<0.05).(2)The EPVS score of SAO subtype was higher than that of LAA subtype and the control group,the difference was significant(P<0.05)(.3)The domains of cognitive damage in LAA and SAO were different,and the two groups showed significant differences in visual space,executive ability and attention(P<0.05).Conclusion:The LAA and SAO two subtypes of acute cerebral infarction have cognitive impairment in the early stage,and the cognitive impairment domains are different;the EPVS may be related to vascular cognitive impairment.