摘要
目的探讨脑白质疏松(LA)对急性缺血性卒中患者认知功能的影响。方法选择2016年3月～2017年2月我院收治的起病14 d内的首发急性缺血性卒中患者,共91例,所有患者完成MRI检查,依据头颅MRI是否存在LA,分为LA组74例,无LA组17例。并对脑白质疏松严重度进行评分,卒中后3个月进行认知功能评估,认知功能评定采用MoCA量表和MMSE量表。结果 LA组整体认知功能(MMSE、MoCA评分)及视空间执行功能、语言功能、记忆功能评分低于无LA组,差异有统计学意义(P<0.05),其他领域认知功能比较,差异无统计学意义(P>0.05),LA严重度与MMSE、MoCA评分呈负相关,Spearman相关系数分别为r=-0.25、-0.28,P值分别为0.02、0.01。LA组中轻度LA患者(LA评分≤3分)30例,与无LA组比较,二者整体认知功能、视空间执行功能、命名、注意、语言、抽象、记忆及定向功能比较,差异无统计学意义(P>0.05)。Logistic回归分析显示脑白质疏松的严重程度是急性缺血性卒中后3个月痴呆的危险因素。结论脑白质疏松影响急性缺血性卒中患者的整体认知功能及视空间执行功能、语言、记忆功能,且LA程度越重,对认知功能影响越大,但轻度的LA对认知功能影响不明显,LA严重度是急性缺血性卒中后3个月痴呆的重要危险因素。但本研究仅仅是一单中心横断面研究,缺乏LA对认知功能长期影响的资料,有必要开展长期随访的多中心研究对其进行进一步的阐述。
Objective To investigate the effect of leukoaraiosis(LA)on cognitive function in patients with acute ischemic stroke.Methods A total of 91 patients with acute ischemic stroke within 14 days from March 2016 to February 2017 were enrolled.All patients underwent MRI and were divided into LA groups according to the presence or absence of LA in the head MRI.74 cases,17 cases without LA group.The severity of leukoaraiosis was scored,and cognitive function was assessed 3 months after stroke.The cognitive function was assessed using the MoCA scale and the MMSE scale.Results The overall cognitive function(MMSE,MoCA score)and visual spatial function,language function and memory function score of LA group were lower than those without LA group,the difference was statistically significant(P<0.05),and the cognitive function in other fields was compared.There was no statistical significance(P>0.05),LA severity was negatively correlated with MMSE and MoCA scores,and Spearman correlation coefficients were r=-0.25 and-0.28,respectively,and P values were 0.02 and 0.01,respectively.In the LA group,30 patients with mild LA(LA score≤3 points),compared with the non-LA group,the overall cognitive function,visual spatial executive function,naming,attention,language,abstraction,memory and orientation function comparison,difference was not statistically significant(P>0.05).Logistic regression analysis showed that the severity of leukoaraiosis was a risk factor for dementia 3 months after acute ischemic stroke.Conclusion Leukoaraiosis affects the overall cognitive function and visual function,language and memory function of patients with acute ischemic stroke.The more severe the LA,the greater the impact on cognitive function,but the mild LA on cognitive function.The effect was not obvious,LA severity was an important risk factor for dementia 3 months after acute ischemic stroke.However,this study is only a single-center cross-sectional study,lacking the data on the long-term effects of LA on cognitive function,and it is necessary to car
作者
杨艳
王思迅
宋春江
YANG Yan;WANG Si-xun;SONG Chun-jiang(Department of Neurology,the Sixth People's Hospital of Chengdu,Chengdu 610051,Sichuan,China)
出处
《医学信息》
2019年第1期88-91,共4页
Journal of Medical Information
关键词
脑白质疏松
缺血性卒中
认知障碍
Leukoaraiosis
Ischemic stroke
Cognitive impairment
