腔隙性脑梗死后非痴呆性血管性认知障碍的临床相关研究

发布时间：2018-08-14 16:29

【摘要】：目的:探讨腔隙性脑梗死(LI)后合并非痴呆性血管性认知障碍(VCIND)患者的临床特点及认知影响因素。方法:选择2015年12月—2016年6月就诊于新疆医科大学第一附属医院的符合LI诊断标准的患者120例,参照认知相关神经量表进行评分,筛选出LI中符合VCIND患者76例(VCIND组),在剩余患者中选择认知正常患者44例作为对照组(NC组),对两组的年龄、性别、受教育年限、吸烟史、高血压史、糖尿病史、高同型半胱氨酸血症史、短暂性脑缺血发作(TIA)史、脑血管狭窄程度分级、脑白质病变评分及认知功能评分进行比较,分析上述因素与LI后VCIND的关系。结果:两组患者MoCA量表子项进行比较后在视空间及执行功能、抽象能力、命名能力、注意力等方面存在差异(P0.05),且VCIND组以执行功能、抽象能力、延迟回忆能力受损为主。对两组患者的年龄、受教育时长、高血压史、精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分比较,差异均有统计学意义(P0.05)。NC组患者的脑血管狭窄程度分级、深部脑白质评分均优于VCIND组(P0.05)。进行Logistic回归分析后提示血管狭窄程度为3、4级,深部脑白质病变评分为3分是LI后VCIND的危险因素,受教育时间长是LI后VCIND的保护因素(P0.05)。结论:LI后VCIND患者的认知功能在执行能力、命名、注意、抽象能力、延迟回忆能力等方面存在损害,以执行功能受损为主,脑血管狭窄程度中度以上和严重的深部脑白质病变与LI后VCIND患者的认知损害相关。
[Abstract]:Objective: to investigate the clinical features and cognitive influencing factors of patients with nondementia vascular cognitive impairment (VCIND) after lacunar cerebral infarction (LI). Methods: from December 2015 to June 2016, 120 patients who met the criteria of Li diagnosis in the first affiliated Hospital of Xinjiang Medical University were selected and scored according to the Cognitive related nerve scale. 76 patients (VCIND group) with Li and 44 patients with normal cognition were selected as control group (NC group). The age, sex, years of education, smoking history, hypertension history and diabetes history were compared between the two groups. The history of hyperhomocysteinemia, the history of transient ischemic attack (TIA), the grade of cerebral vascular stenosis, the score of leukoencephalopathy and the score of cognitive function were compared, and the relationship between the above factors and VCIND after Li was analyzed. Results: there were differences in visual space, executive function, abstract ability, naming ability and attention between the two groups after the comparison of sub-items of MoCA scale (P0.05), and the VCIND group was mainly impaired in executive function, abstract ability and delayed recall ability. There were significant differences in age, duration of education, history of hypertension, mental state examination scale (MMSE) and Montreal Cognitive Assessment scale (MoCA) between the two groups (P0.05). The white matter score of deep brain was better than that of VCIND group (P0.05). Logistic regression analysis showed that the degree of vascular stenosis was 3 grade 4, the score of deep white matter lesion 3 was the risk factor of VCIND after Li, and the long time of education was the protective factor of VCIND after Li (P0.05). Conclusion the cognitive function of patients with VCIND after VCIND was impaired in the aspects of executive ability, naming, attention, abstract ability, delayed recall, etc. Severe and moderate cerebral vascular stenosis was associated with cognitive impairment in patients with VCIND after Li.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.13

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