脑白质疏松症对缺血性卒中患者预后及认知功能的影响

Prognosis of ischemic stroke patients with leukoaraiosis and effects of different degrees of LA on cognitive function

目的:探讨脑白质疏松症(LA)对缺血性卒中患者预后及认知功能的影响。方法:回顾性分析2017年8月至2019年8月该院收治的92例缺血性卒中患者临床资料,根据患者是否合并LA分为对照组(单纯缺血性卒中)和观察组(缺血性卒中合并LA)各46例,观察组根据LA严重程度又分为轻度组(n=20)、中度组(n=16)和重度组(n=10)。比较各组入院时、发病10 d、发病20 d和随访30 d时美国国立卫生研究院卒中量表(NIHSS)评分和改良Rankin量表(MRS)评分,比较轻度组、中度组和重度组简易智力状态检查量表(MMSE)评分和蒙特利尔认知评估量表(MoCA)评分。结果:入院时、发病10 d、发病20 d和随访30 d时,观察组NIHSS和MRS评分均明显高于对照组,差异有统计学意义(P<0.05);入院时、发病10 d、发病20 d和随访30 d时,各组NIHSS和MRS评分比较,轻度组<中度组<重度组,差异有统计学意义(P<0.05);各组MMSE和MoCA评分比较,轻度组>中度组>重度组,差异有统计学意义(P<0.05)。结论:缺血性卒中合并LA患者的NIHSS和MRS评分均高于单纯缺血性卒中患者,且LA程度越严重患者认知功能越差。

Objective: To explore prognosis of ischemic stroke patients with leukoaraiosis(LA) and effects of different degrees of LA on cognitive function. Methods: The clinical data of 92 patients with ischemic stroke admitted to our hospital from August 2017 to August 2019 were retrospectively analyzed. According to whether the patients were complicated with LA or not, they were divided into control group(ischemic stroke only) and observation group(ischemic stroke complicated with LA), 46 cases in each group. The observation group was further divided into mild group(n=20), moderate group(n=16) and severe group(n=10) according to the severity of LA. The scores of the National Institute of Health stroke scale(NIHSS) and the modified Rankin scale(MRS) scores on admission, the 10 and 20 days of the onset, and 30 days of follow-up were compared among these groups. Then, the mini-mental state examination(MMSE) score and the Montreal cognitive assessment scale(MoCA) scores were compared among the mild group, the moderate group and the severe group. Results: The NIHSS and MRS scores of the observation group were significantly higher than those of the control group on admission, the 10 and 20 days of the onset, and 30 days of follow-up, and the differences were statistically significant(P<0.05). On admission, on 10 and 20 days of the onset, and 30 days of follow-up, the NIHSS and MRS scores of the mild group, the moderate group and the severe group were compared: the mild group < the moderate group < the severe group, the differences were statistically significant(P<0.05). Further, the comparison of MMSE and MoCA scores among the mild group, the moderate group and the severe group showed that the mild group > the moderate group > the severe group, and the differences were statistically significant(P<0.05). Conclusions: The NIHSS score and MRS score of the ischemic stroke patients with LA are higher than those of the ischemic stroke patients alone. The more severe the degree of LA is, the greater the effects on the cognitive function of patients are.