无症状脑梗死患者认知功能与静态平衡功能的关系

The Relationship between Cognitive Function and Static Balance Function in Patients with Silent Brain Infarction

目的:探讨无症状脑梗死(SBI)患者认知功能与静态平衡功能的关系,为其临床治疗提供依据。方法:选取2021年10月—2022年6月于福建中医药大学附属第二人民医院健康管理中心行颅脑磁共振成像(MRI)并确诊为SBI患者60例,根据蒙特利尔认知评估量表(MoCA)评分的不同分为认知正常组和轻度认知障碍组,各30例,比较两组静态平衡功能。结果:与轻度认知障碍组比较,认知正常组MoCA的视空间与执行能力、命名、注意、语言、抽象、延迟回忆得分均高于轻度认知障碍组,差异均有统计学意义(P<0.05)。两组定向力得分比较,差异无统计学意义(P>0.05)。轻度认知障碍组的视觉依赖性高于认知正常组,差异有统计学意义(P<0.05)。两组平衡稳定性系数和本体感觉系数评价各等级占比差异均无统计学意义(P>0.05)。认知正常组的重心偏倚幅度评价与平衡指数评价均优于轻度认知障碍组,差异均有统计学意义(P<0.05)。结论:与认知正常者相比,SBI伴轻度认知功能障碍者具有较大的视觉依赖性、更大的重心偏移幅度和更差的平衡指数,推测SBI患者的认知功能障碍与静态平衡功能的下降可能具有一定相关性,建议对SBI伴认知障碍者进行平衡功能筛查以评估跌倒风险。

Objective:To investigate the relationship between cognitive function and static balance function in patients with silent brain infarction(SBI),and to provide a basis for clinical treatment.Method:A total of 60 patients who underwent brain magnetic resonance imaging(MRI)and diagnosissd of the SBI at Health Management Center of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine from October 2021 to June 2022 were selected and divided into the normal cognitive group and the mild cognitive impairment group,according to the differences of the Montreal cognitive assessment scale(MoCA)score,with 30 cases in each group.The static balance function of the two groups was compared.Result:Compared with the mild cognitive impairment group,the normal cognitive group had significantly higher scores of visuospatial and executive ability,naming,attention,language,abstraction,and delayed recall in MoCA,the differences were statistically significant(P<0.05).There was no significant difference in orientation score between the two groups(P>0.05).The visual dependence of the mild cognitive impairment group was higher than that of the normal cognitive group,the difference was statistically significant(P<0.05).There were no significant differences in the proportion of each grade in the evaluation of balance stability coefficient and proprioception coefficient between the two groups(P>0.05).The evaluation of gravity center bias and the evaluation of balance index in the normal cognitive group were better than those in the mild cognitive impairment group,the differences were statistically significant(P<0.05).Conclusion:Compared with those normal cognition,SBI patients with mild cognitive impairment have greater visual dependence,larger center of gravity shift and worse balance index,suggesting that cognitive impairment in SBI patients may be correlated with the decline of static balance function,balance function screening is recommended for SBI patients with mild cognitive impairment to assess the risk of falls.