合并认知障碍的腔隙性脑梗死患者的病灶特点

The focal lesion distribution characteristics of lacunar cerebral infarction patients with cognitive impairment

目的探讨腔隙性脑梗死(LI)合并认知障碍的病灶特点。方法本研究选择2021年1月~2022年1月100例LI患者为研究对象,均进行头颅MRI检查。评估患者合并认知功能情况,设为认知障碍组以及非认知障碍组,比较两组患者一般资料、病灶数量、是否为多发病灶、病灶分布、位置等MRI特点。结果100例LI患者合并认知障碍34例,认知障碍组MRI检查发现病灶85处,非认知障碍组114处,认知障碍组平均病灶检出数显著高于非认知障碍组(P<0.05);认知障碍组年龄、病程显著高于对照组(P<0.05),两组性别、文化程度差异无统计学意义(P>0.05);认知障碍组多发病灶、左侧病灶检出率均显著高于非认知障碍组,右侧病灶检出率低于非认知障碍组(P<0.05),双侧病灶检出率差异无统计学意义(P>0.05);认知障碍组丘脑、额叶、基底节病灶检出率高于非认知障碍组,颞叶、丘脑病灶检出率低于非认知障碍组(P<0.05),幕下病灶检出率差异无统计学意义(P>0.05)。结论LI合并认知障碍率较高,MRI成像显示病灶数目多、左侧大脑病灶、病灶累及丘脑、额叶、基底节等可能更易引起认知障碍。

Objective To explore the focal lesion distribution characteristics of lacunar cerebral infarction(LI)with cognitive impairment.Methods A total of 100 patients with LI from January 2021 to January 2022 were selected as the study subjects.The patients'combined cognitive function were assessed,and they were set as the cognitive impairment group and the non-cognitive impairment group.The MRI features of the two groups,such as general information,the number of symptoms,whether it is multiple lesions,the distribution and the location of the lesions were compared.Results There were 34 cases of cognitive impairment in 100 LI patients,85 lesions in the cognitive impairment group and 114 lesions in the non-cognitive impairment group.The average number of lesions in the cognitive impairment group was significantly higher than that in the non-cognitive impairment group(P<0.05).The age and course of disease in the cognitive impairment group were significantly higher than those in the control group(P<0.05),but there was no significant difference in gender and educational level between the two groups(P>0.05).The detection rate of multiple lesions and left lesions in cognitive impairment group was significantly higher than that in non-cognitive impairment group,and the detection rate of right lesions was lower than that in non-cognitive impairment group(P<0.05).There was no significant difference in the detection rate of bilateral lesions(P>0.05).The detection rate of thalamus,frontal lobe and basal ganglia lesions in cognitive impairment group was higher than that in non-cognitive impairment group,while the detection rate of temporal lobe and thalamus lesions was lower than that in non-cognitive impairment group(P<0.05).There was no significant difference in the detection rate of infratentorial lesions(P>0.05).Conclusion The rate of LI combined with cognitive impairment is high.MRI imaging shows that the number of lesions,left brain lesions,and lesions involving the thalamus,frontal lobe,basal ganglia,etc.may be more likely to cause cognitive impairment.