摘要
目的探讨卒中后失语患者非语言认知功能损害的特点,并分析卒中后失语患者语言障碍与非语言性认知功能损害之间的关系。方法选择2017年5月-2018年6月就诊的卒中患者共32例,经西方失语症成套测验(westernaphasia battery,WAB)评估语言功能,分为失语组和无失语组,其中失语组15例,无失语组17例。洛文斯顿成套测验中文版(Loewenstein occupational therapy cognitive assessment,LOTCA)第2版评估患者非语言认知功能。对失语组与非失语组的LOTCA各分项分值及总分分别进行非参数检验;对WAB中各分项得分及失语商与LOTCA各认知分项得分及总分进行偏相关分析,并行多元逐步回归分析。结果失语组的LOTCA总分低于无失语组,差异有统计学意义[85.0(69.0～92.0)分vs99.0(86.0～102.5)分,P<0.05];失语患者LOTCA总分与WAB各分项及失语商呈正相关(r=0.587～0.883,均P<0.05),WAB分项中的各分项与LOTCA中各分项之间呈正相关(r=0.521～0.843,均P<0.05);多元逐步回归分析显示,影响患者失语商的主要因素为LOTCA总分(β=0.707,P=0.003)。结论卒中后失语患者存在非语言认知功能障碍,失语程度越重其非语言认知功能受损程度越重。
Objective To explore the characteristics of non-linguistic cognitive impairment in patients with post-stroke aphasia,and to analyze the relationship between language impairment and nonlinguistic cognitive impairment in patients with aphasia after stroke.Methods Thirty-two patients with stroke in Beijing Tian Tan Hospital were selected.The language function of all the patients during hospitalization were assessed by Western Aphasia Battery(WAB),and they were divided into aphasia group(n=15)and non-aphasia group(n=17).The non-linguistic cognitive function were assessed by the second edition of the Chinese version of Loewenstein Occupational Therapy Cognitive Assessment(LOTCA)battery.The sub-item and total scores of LOTCA in the two groups were compared,and the sub-item scores of WAB and the sub-item and total scores of LOTCA were analyzed by partial correlation analysis.Parallel multiple stepwise regression analysis was conducted to identify the factors influencing aphasic quotient.Results The total score of LOTCA in aphasia group was significantly lower than that in non-aphasia group[85.0(69.0-92.0)vs 99.0(86.0-102.5),P<0.05].The total score of LOTCA were positively correlated with WAB sub-item scores and aphasia quotient(r=0.587-0.883,P<0.05),the sub-item scores of LOTCA were positively correlated with WAB sub-item scores(r=0.521-0.843,P<0.05),and multiple stepwise regression analysis showed that the main factor affecting aphasia quotient was the total score of LOTCA(β=0.707,P=0.003).Conclusions There is non-linguistic cognitive impairment in patients with aphasia after stroke.The more severe aphasia,the more severe non-linguistic cognitive impairment.
作者
刘鑫鑫
马艳玲
刘艳君
姚婧璠
张玉梅
LIU Xin-Xin;MA Yan-Ling;LIU Yan-Jun;YAO Jing-Fan;ZHANG Yu-Mei(Beijing Tian Tan Hospital, Capital Medical University,China National Clinical Research Center for Neurological Diseases,Center of Stroke, Beijing Institute for Brain Disorders,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China)
出处
《中国卒中杂志》
2019年第2期116-120,共5页
Chinese Journal of Stroke
基金
国家重点研发项目"老年常见神经系统疾病综合康复体系研究"分课题"老年全周期康复技术体系与信息化管理研究"(SQ2018YFC200065-02)
北京市医管局"扬帆计划"重点医学扶持项目(ZYLX201836)
国家自然科学基金面上项目(8137120)
