摘要
目的探讨老年腔隙性脑梗死部位与认知功能障碍的关系及随时间发展的趋势。方法选择98例老年腔隙性脑梗死患者，另选同期健康体检的老年人60例为对照组。分别对患者急性期（脑梗死发生3～4周）、12个月、24个月以及对照组采用中文版蒙特利尔认知评估量表（MoCA）进行认知功能评估，观察腔隙性脑梗死部位与认知功能障碍的关系及随时间发展的趋势。结果各部位腔隙性脑梗死患者注意力集中、执行功能得分均显著低于对照组，病变部位在小脑区的患者记忆得分显著低于其他各组，病变部位在大脑皮层的患者命名得分显著低于其他各组，病变部位在小脑区和脑干区的患者定向力得分显著低于其他各组。病变部位在内囊及基底节区、脑干区、大脑皮层区与小脑区的患者抽象思维和语言得分显著低于病变部位在丘脑区的患者和对照组。随访结果发现，各病变部位的患者在24个月随访的 MoCA 得分总分均显著低于急性期的得分。差异均有统计学意义（ P ﹤0.05）。结论老年腔隙性脑梗死患者存在认知功能障碍，其认知功能障碍与梗死的部位相关，且随着病变进展出现缓慢恶化的趋势。
Objectine To explore the relationship between site and cognitive dysfunction in elderly patients with lacunar infarction and their developing trends. Methods A total of 98 elderly patients with lacunar infarctions were allocated in this study,and 60 elderly healthy volun-teers were enrolled in control group. Chinese edition of the Montreal Cognitive Assessment（MoCA）had been used to evaluate the cognitive func-tion. Relationship between the site of lacunar infarction and cognitive dysfunction had been observed and the development of trends over time had been followed - up. Results In patients with various parts of lacunar infarctions,the scores of executive function were significantly lower than those of control group. In patients with lesions in cerebellum region,memory scores were significantly lower than those of other groups. In patients with lesions in cerebral cortex,scores were significantly lower than those of other groups. In patients with lesions in cerebellar and brainstem re-gions,scores of disorientation were significantly lower than those of other groups. The thinking and language scores in patients with cystic lesions and lesions in basal ganglia,brainstem and cerebellum,cortical area,thinking and language scores were significantly lower than those of patients with lesion in hypothalamus region and control groups. The results of follow - up for 24 months demonstrated that MoCA scores in patients with le-sions at any part were significantly lower than those of patients in acute phase,and their difference was significant（ P ﹤ 0. 05）. Conclusion Elderly patients with lacunar infarctions exsit cognitive dysfunction,the cognitive impairment in lacunar infarction is correwsponding to the site of infarction in elderly patients,and they have the trend of slow progress of worsening of the disease.
出处
《临床和实验医学杂志》
2015年第18期1518-1521,共4页
Journal of Clinical and Experimental Medicine
