腔隙性脑梗死患者认知功能障碍与颅脑MRI显示脑白质变化的关系

Relationship between Cognitive Dysfunction and Brain White Matter Changes Displayed on Brain MRI in Patients with Lacunar Cerebral Infarction

目的:分析腔隙性脑梗死患者认知功能障碍与颅脑磁共振成像(MRI)显示脑白质变化的关系。方法:选取2021年1月—2023年12月广西壮族自治区江滨医院收治的98例腔隙性脑梗死患者作为研究对象,均接受MRI检查,并采用简明精神状态检查量表(MMSE)及蒙特利尔认知功能评估量表(MoCA)评估患者认知功能,并依据MRI检查结果将患者分组,比较不同分组患者临床资料,并采用Spearman相关性分析腔隙性脑梗死MRI脑白质变化与上述量表评分的关系。结果:98例患者经MRI检查,依据脑白质病变分级标准,0级19例(0级组),1级26例(1级组),2级30例(2级组),3级23例(3级组)。四组临床资料比较,差异无统计学意义(P>0.05)。四组MMSE评分、MoCA评分比较,差异有统计学意义(P<0.05);Spearman相关性分析显示,腔隙性脑梗死患者脑白质病变程度与MMSE评分、MoCA评分呈负相关(r=-0.823、-0.808,P<0.05)。结论:腔隙性脑梗死患者认知功能障碍与其脑白质病变有关,相关认知功能评分与脑白质病变严重程度呈负相关,临床可依据脑白质病变情况对患者认知功能损害进行预估。

Objective:To analyze the relationship between cognitive dysfunction and brain white matter changes displayed on brain magnetic resonance imaging(MRI)in patients with lacunar cerebral infarction.Method:A total of 98 patients with lacunar cerebral infarction who admitted to Jiangbin Hospital of Guangxi Zhuang Autonomous Region from January 2021 to December 2023 were selected as the study subjects,all patients were given MRI examination,and their cognitive function were evaluated using the mini mental state examination(MMSE)and Montreal cognitive assessment scale(MoCA).Based on the MRI examination results,the patients were grouped,and the clinical data of different groups were compared,Spearman correlation analysis was used to analyze the relationship between MRI white matter changes in lacunar infarction and the above scale scores.Result:A total of 98 patients were examined by MRI,according to the grading standard of white matter lesions,19 cases of grade 0(grade 0 group),26 cases of grade 1(grade 1 group),30 cases of grade 2(grade 2 group),23 cases of grade 3(grade 3 group).There were no significant differences in clinical data among four groups(P>0.05).There were significant differences in MMSE score and MoCA score among four groups(P<0.05).Spearman correlation analysis showed that the degree of white matter lesions in patients with lacunar infarction was negatively correlated with MMSE score and MoCA score(r=-0.823,-0.808,P<0.05).Conclusion:Cognitive dysfunction in patients with lacunar cerebral infarction is related to white matter lesions,related cognitive function scores are negatively correlated with the severity of white matter lesions,clinically,cognitive impairment can be estimated based on white matter lesions.