急性脑小血管闭塞致轻度认知功能障碍相关危险因素的研究

发布时间：2018-03-25 20:35

本文选题：轻度认知功能障碍　切入点：脑小血管闭塞　出处：《内蒙古民族大学》2017年硕士论文

【摘要】：目的:对急性脑小血管闭塞(Small artery occlusion,SAO)致轻度认知功能障碍(Mild cognitive impairment,MCI)的相关危险因素进行单因素及多因素分析,探究可能延缓认知功能障碍发生的可控因素。方法:收集2015年11月至2016年11月就诊于内蒙古民族大学附属医院的神经内科门诊、住院部的急性SAO患者,通过简易精神状态评估量表和蒙特利尔认知评估(Montreal cognitive assessment,Mo CA)量表对患者进行分组,MCI组60例,非认知功能障碍(No cognitive impairment,NCI)组59例。对入选患者的一般临床情况资料、实验室生化指标、颈动脉超声情况、头颅MRI病灶数量和部位进行记录。通过SPSS 22.0统计学软件包对MCI组和NCI组记录资料进行相关危险因素的分析。结果:1.单因素分析,MCI组与NCI组比较高血压病、糖尿病、高脂血症、年龄、Mo CA评分、甘油三酯、血肌酐、纤维蛋白原差异有统计学意义(p0.05);2.多因素分析,高脂血症可能为急性SAO致MCI的独立危险因素;3.MCI组和NCI组小学及其以下与中学及其以上Mo CA评分比较差异均有统计学意义(p0.05),MCI组文化程度与Mo CA评分呈正相关(r=0.460),差异有统计学意义(p0.01);4.MCI组与NCI组比较,颈总动脉处斑块发生率差异有统计学意义(p=0.012),颈动脉内中膜增厚及斑块发生情况差异无统计学意义(p0.05),颈动脉单侧、双侧、分叉处、颈内动脉的斑块发生率差异无统计学意义(p0.05);5.MCI组与NCI组比较,病灶右侧、双侧分布差异有统计学意义,病灶单发、多发、左侧分布差异无统计学意义;6.两组头颅MRI病灶数量比较差异有统计学意义(p=0.002),脑桥、侧脑室旁病灶发生比较差异有统计学意义(p0.05),延髓、小脑、丘脑、基底节区、半卵圆中心、额区、顶枕区、颞区病灶发生比较无统计学差异(p0.05)。结论:年龄、高血压病、糖尿病、高脂血症、甘油三酯、血肌酐、纤维蛋白原可能是急性SAO致MCI的相关危险因素,高脂血症可能是其独立危险因素,文化程度、颈动脉斑块发生部位可能与急性SAO致MCI有关,腔隙性脑梗死的病灶分布、部位和数量可能与急性SAO致MCI有关。
[Abstract]:Objective: to investigate the risk factors associated with mild cognitive impairment (mild cognitive impaction) in patients with acute small artery occlusion (SAO). Methods: from November 2015 to November 2016, we collected patients with acute SAO in the Department of Neurology, Department of Neurology, affiliated Hospital of Inner Mongolia University for nationalities, from November 2015 to November 2016. The patients were divided into MCI group (n = 60) and no cognitive impairment group (n = 59). The general clinical data and laboratory biochemical indexes were analyzed. Carotid ultrasound, the number and location of head MRI lesions were recorded. The data of MCI and NCI were analyzed by SPSS 22.0 statistical software package. Results 1. Univariate analysis showed that hypertension was compared between MCI group and NCI group. Diabetes mellitus, hyperlipidemia, age Mo CA score, triglyceride, serum creatinine, fibrinogen were significantly different. The independent risk factors of hyperlipidemia may be MCI caused by acute SAO. 3. There are significant differences in the scores of Mo CA between primary school and middle school and middle school in MCI group and NCI group. There is a positive correlation between education level and Mo CA score in MCI group and NCI group, and there is a positive correlation between the educational level of MCI group and Mo CA score, and the difference is significant. There was significant difference between MCI group and NCI group. There was significant difference in the incidence of plaque in common carotid artery (P 0.012). There was no significant difference in carotid intima media thickening and plaque occurrence (P 0.05). The carotid artery was unilateral, bilateral and forked. There was no significant difference in plaque incidence of internal carotid artery between MCI group and NCI group. There were significant differences in the distribution of right and bilateral lesions between MCI group and NCI group. There was no significant difference in the number of brain MRI lesions between the two groups. There were significant differences in the number of brain MRI lesions between the two groups. There were significant differences in p0. 05, medulla, cerebellum, thalamus, basal ganglia region, center of semiovale, pons and paraventricular lesions. Conclusion: age, hypertension, diabetes mellitus, hyperlipidemia, triglyceride, serum creatinine and fibrinogen may be the risk factors of acute SAO induced MCI. Hyperlipidemia may be an independent risk factor, education level, carotid plaque location may be associated with acute SAO induced MCI, lacunar cerebral infarction focus distribution, location and number of acute SAO may be related to MCI.
【学位授予单位】：内蒙古民族大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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