脑微出血的危险因素及其对认知功能影响的临床研究

发布时间：2018-07-03 09:48

本文选题：脑梗死 + 脑出血　；参考：《中华老年心脑血管病杂志》2014年07期

【摘要】：目的探讨腔隙性脑梗死患者脑微出血(CMB)的危险因素及其对认知功能影响。方法选择腔隙性脑梗死患者113例,根据头颅MRI磁敏感加权成像(SWI)检查结果分为CMB组33例和无CMB组80例。比较2组患者的一般临床资料及生化指标,并进一步回归分析CMB发生的相关危险因素。于入院后第2天应用蒙特利尔认知评估量表(MoCA)对患者的认知功能进行评估。结果 CMB组收缩压和同型半胱氨酸(Hcy)高于无CMB组[(158.3±13.7)mm Hg vs(138.2±15.2)mm Hg(1mm Hg=0.133kPa)和(13.7±4.5)μmol/L vs(9.4±2.4)μmol/L],差异有统计学意义(P=0.000);CMB组总胆固醇低于无CMB组[(4.2±0.9)mmol/L vs(4.9±0.8)mmol/L],差异有统计学意义(P=0.000);与无CMB组比较,CMB组的MoCA总分、视空间与执行功能和注意得分明显降低[(22.98±2.30)分vs(27.49±1.15)分、(2.73±0.94)分vs(3.78±0.66)分及(3.70±1.35)分vs(4.23±1.08)分],差异有统计学意义(P=0.000,P=0.030)。logistic回归分析显示,Hcy是CMB的独立危险因素(OR=0.735,95%CI:0.532~0.921,P=0.001)。结论 Hcy是CMB的独立危险因素;CMB会引起认知功能障碍,表现为视空间与执行功能和注意障碍。
[Abstract]:Objective to investigate the risk factors of cerebral microhemorrhage (CMB) and its effect on cognitive function in patients with lacunar infarction. Methods 113 patients with lacunar infarction were divided into CMB group (n = 33) and non-CMB group (n = 80) according to the results of cranial MRI magnetic sensitivity weighted imaging (SWI). The general clinical data and biochemical indexes were compared and the risk factors of CMB were further analyzed. The second day after admission, Montreal Cognitive Assessment scale (MoCA) was used to evaluate the cognitive function of the patients. Results systolic blood pressure (SBP) and homocysteine (Hcy) in CMB group were significantly higher than those in CMB group [(158.3 卤13.7) mm Hg vs (138.2 卤15.2) mm Hg (1mm Hg 0.133 KPA) and (13.7 卤4.5) 渭 mol / L vs (9.4 卤2. 4) 渭 mol / L], and the total cholesterol in CMB group was significantly lower than that in CMB group [(4.2 卤158.3) mmol / L vs (4.9 卤0. 8) mmol / L] (P < 0. 000). The scores of visual space and executive function and attention were significantly decreased [(22.98 卤2.30) vs (27.49 卤1.15), (2.73 卤0.94) vs (3.78 卤0.66) and (3.70 卤1.35) vs (4.23 卤1.08)], the difference was statistically significant (P0.000P0.030). Logistic regression analysis showed that Hcy was an independent risk factor for CMB. Conclusion Hcy is an independent risk factor for CMB. CMB may cause cognitive impairment, which is characterized by visual space, executive function and attention disorder.
【作者单位】：安徽医科大学附属合肥医院;合肥市第二人民医院神经内科;
【基金】：安徽省科技计划项目(1301043051)
【分类号】：R743.34

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