脑白质疏松症与Binswanger病认知功能障碍的对比研究

A comparing study of mild cognitive impairment and dementia in pure leukoaraiosis and Binswanger's disease

目的 探讨轻度认知功能障碍与痴呆在单纯脑白质疏松症(LA)、Binswanger病(BD)及脑白质疏松症合并脑梗死(LA+CI)中的临床诊断价值。方法 单纯LA组27例,BD组33例,LA+CI组31例,对照组30例,行简易精神状态量表(MMSE)、临床记忆量表测验(CMS)、轻度认知功能障碍的认知评定并对比分析。结果 单纯LA组、BD组、LA+cI组MMSE及CMS成绩均明显低于对照组,差异有显著意义(P<0.05);单纯LA组MMSE及CMS成绩明显高于BD组、LA+CI组,差异有显著意义(P<0.05);单纯LA组认知损害以轻度认知功能障碍为主(77.8％),无1例痴呆;BD组中度认知功能障碍占24.2％,痴呆占75.8％;LA+CI组以中度认知功能障碍(19.4％)和痴呆(77.4％)为主。结论 轻度认知功能障碍是诊断单纯LA的临床参考指标。中度认知功能障碍和痴呆是诊断BD和IA+CI的临床参考指标。

Objective To investigate the clinical value of mild cognitive impairment and dementia in the diagnosis of pure leukoaraiosis, Binswanger' s disease and cerebral infarction with leukoaraiosis. Methods The mini-mental-status examination(MMSE), the Clinic-monery-status examination(CMS) and the evaluation of cognitive of mild cognitive impairment were performed for 27 patients with leukoaraiosis, 33 patients with Bswanger's disease, 31 patients of cerebral infarction with leukoaraiosis and 30 persons of healthy central group. The data was analysed and compared. Results (1) The scores of MMSE and CMS of pure leukoaraiosis group, Binswanger's disease group, and cerebral infarction with leukoaraiosis group were significently lower than that in healthy central group(P <0.05). (2) The scores of MMSE and CMS of pure leukoaraiosis group were significently higher than both Bin-swanger's disease group and cerebral infarction with leukoaraiosis group(P<0.05). (3) The mild cognitive impairment was predominant in pure leukoaraiosis group (77.8 percent), without case of dementia; There was 24.2 percent of moderate cognitive impairment and 75.8 percent of dementia in Binswanger's disease group; The moderate cognitive impairment accounted for 19.4 percent and dementia accounted for 77.4 percent of cases in cerebral with leukoaraisis group. Conclusions (1) Mild cognitive impairment is the clinical marker of the diagnosis of pure leukoaraisis. (2) Moderate cognitive impairment and dementia are clinical markers of Binswanger's disease and cerebral infarction with leukoaraiosis.