摘要
目的应用神经心理学测验研究不同部位脑梗死与认知功能障碍的关系,并摸索不同部位脑梗死致认知功能损害的特点,为有针对性的施行康复训练提供理论参考。方法收集100例初发脑梗死的急性期患者,包括丘脑12例,额叶20例,颞叶16例,基底节37例,脑干15例,运用蒙特利尔认知评估量表(Mo CA)、日常生活能力量表(ADL)、缺血指数量表(HIS)对研究对象进行综合认知功能评估,记录各认知域的Mo CA分值并评估,确定患者受损的认知功能域。结果丘脑梗死患者在语言、注意力、视空间及执行能力、延迟回忆项目评分均降低,以语言项目降低最明显(P<0.05)。额叶梗死患者在视空间及执行能力、定向力、注意力及延迟回忆项目分值均降低,尤以视空间及执行能力项目降低最为明显(P<0.05)。颞叶梗死患者在命名、延迟回忆、视空间及执行能力、定向力项目分值降低,以命名及延迟回忆项目降低最为明显(P<0.05)。基底节梗死患者在语言、注意力、延迟回忆、定向力、视空间及执行能力项目评分均有所降低,但与其他组比较降低程度没有统计学差异。脑干梗死患者认知功能评分变化无统计学意义。结论脑梗死患者认知障碍的发生与梗死部位有关,且不同部位梗死后认知功能损害的表现有所不同。
Objective The relationship between different types of cerebral infarction and features of cognitive dysfunction was discussed. The study also mentioned the possibility of more accurate rehabilitation training according to the types of cerebral infarction.Methods 100 patients with first-ever cerebral infarction were recruit,including 12 patients with thalamus infarction,20 patients with frontal lobe infarction,16 patients with temporal lobe infarction,37 patients with basal ganglia infarction and 15 patients with brain stem infarction. MoCA,ADL and HIS scale were adapted to evaluate the patients comprehensive cognitive abilities. The domanial cognitive functions evaluated by MoCA were analyzed in detail to ascertain the cognitive dysfunction of different infarction.Results The abilities of language,attention,visual space,execution and delayed recal were damaged in patients with thalamus infarction. The ability of language was lowered the most obviously in this group（P〈 0.05）. As to the patients with frontal infarction, visual spacial and executive ability,orientation,attention and delayed recal decreased significantly. The decline of visual spacial and executive ability were had statistical difference（P〈 0.05）. In the temporal group,the scores of naming,delayed recal,visual spacial and executive ability and orientation decreased,naming and delayed recal preceded the others（P〈 0.05）. The infarction of basal ganglia caused a general decline in the ability of language,attention,delayed recal,orientation,visual spacial and executive functions. But compared to other groups,there was no statistical difference. At last,it seemed that there was no cognitive decrease in the patients with brain stem infarction.Conclusion The presentation of cognitive dysfunction is related to the position of infarction. And the manifestation of cognitive lesion is also corelated to different types of cerebral infarction.
出处
《中国卫生标准管理》
2015年第24期46-49,共4页
China Health Standard Management
基金
缺血性脑血管病认知功能障碍的分类研究
黑龙江省自然科学基金资助项目(D201143)
关键词
不同部位脑梗死
认知功能障碍
神经心理学
Different types of cerebral infarction
Cognitive dysfunction
Neuropsychological
