视网膜神经纤维层厚度与轻型缺血性卒中患者认知功能相关性研究

Correlation between retinal nerve fiber layer thickness and cognitive function in patients with mild ischemic stroke

目的探究轻型缺血性卒中患者视网膜神经纤维层(RNFL)厚度与认知功能障碍之间的相关性。方法纳入2020年1月至2021年12月河北省承德市中心医院诊断与治疗的146例轻型缺血性卒中患者,采用光学相干断层扫描术测定双眼各象限RNFL厚度,简易智能状态检查量表(MMSE)和蒙特利尔认知评价量表评价认知功能。结果轻型缺血性卒中患者左眼上方RNFL厚度大于右眼上方(t=-4.589,P=0.000),右眼颞侧RNFL厚度大于左眼颞侧(t=3.639,P=0.000)。相关分析显示,左眼上方RNFL厚度与MMSE评分(r=0.385,P=0.000)、左眼颞侧RNFL厚度与入院时美国国立卫生研究院卒中量表评分(r=0.170,P=0.020)呈正相关,左眼下方RNFL厚度与饮酒史(r=-0.216,P=0.011)、右眼颞侧RNFL厚度与高血压病史(r=-0.194,P=0.023)呈负相关。结论轻型缺血性卒中患者双眼RNFL厚度变薄与认知功能减退具有一定相关性。

Objective To investigate the association between retinal nerve fiber layer(RNFL)thickness and cognitive dysfunction in patients with mild ischemic stroke.Methods Total 146 patients with mild ischemic stroke that diagnosed and treated in Chengde Central Hospital in Hebei from January 2020 to December 2021 were included.Optical coherence tomography(OCT)was used to measure the RNFL thickness in each quadrant of both eyes,and Mini‑Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)were used to evaluate cognitive function.Results In patients with mild ischemic stroke,the RNFL thickness at the superior side of left eye was greater than right eye(t=‑4.589,P=0.000),and the RNFL thickness at the temporal side of right eye was greater than left eye(t=3.639,P=0.000).Correlation analysis showed that the correlation between the RNFL thickness at the superior side of the left eye and the MMSE score(r=0.385,P=0.000),the RNFL thickness at the temporal side of the left eye and the National Institutes of Health Stroke Scale(NIHSS)score at admission(r=0.170,P=0.020)were positively correlated.The correlation between the RNFL thickness at the inferior side of the left eye and the history of drinking(r=‑0.216,P=0.011),the RNFL thickness at the temporal side of the right eye and the history of hypertension(r=‑0.194,P=0.023)were negativley correlated.Conclusions The thinning of RNFL in patients with mild ischemic stroke may have a certain degree of association with cognitive dysfunction.