摘要
目的探讨脑小血管病与认知功能障碍的相关性及临床特点。方法选取2018年1月至2019年7月中国人民解放军南部战区总医院内六科收治的70例危险因素患者作为病例组。采用Fazekas量表评价脑白质病变的严重程度,内侧颞叶萎缩评定量表评价颞叶萎缩的严重程度。择取同期该院与病例组年龄、性别及文化程度等相近的健康体检者75例作为对照组。评估两组蒙特利尔认知评估量表认知功能,并观察两组认知功能量表得分情况,运用Logistic回归模型分析判断脑白质损害(WML)、内侧颞叶萎缩(MTA)及不同部位腔隙性梗死(LI)与认知功能障碍的关系。结果病例组认知功能障碍发生率高于对照组,差异有统计学意义(P<0.05)。两组定向力、注意力与计算力及语言能力比较,差异无统计学意义(P>0.05)。对照组MoCA量表中记忆力、回忆能力、视空间及执行能力等及其总得分低于对照组,差异有统计学意义(P<0.05)。WML、MAT及LI与认知功能障碍关系的相关性分析经Logistic回归模型分析可知,WML[O^R=3.430(95%CI:1.580~7.430),P=0.001]、MAT[O^R=5.050(95%CI:1.930~12.160),P=0.000]及LI[O^R=2.470(95%CI:1.090~6.040),P=0.025]与认知功能障碍呈正相关。结论WML、MAT及LI是导致认知功能障碍的独立危险因素。若对其进行预防与治疗,将较大程度地降低血管性认知功能障碍的发生、发展。
【Objective】To approach the relationship between the cerebrovascular disease and cognitive impairment,and to explore the clinical characteristics of the patients with cognitive impairment.【Methods】Seventy patients with cerebrovascular disease admitted to our hospital from January 2018 to July 2019 were selected as the case group.Fazekas scale was used to evaluate the severity of white matter lesions(WML)and medial temporal lobe atrophy(MAT)scale was used to evaluate the severity of temporal lobe atrophy.Seventy-five healthy subjects in our hospital were selected as the control group.All subjects were assessed with Montreal Cognitive Assessment(MoCA),and the score of cognitive function scale in the two groups was observed.Logistic regression analysis was used to determine the relationship between WML,MAT,lacunar infarction(LI)and cognitive impairment.【Results】Compared with the healthy control subjects,the total score of MoCA in the case group was significantly lower than the normal(P<0.05).The scores of memory,visual space,executive ability and recall ability were significantly lower than those of the control group(P<0.05).According to logistic regression analysis,WML,MAT and LI were closely related to cognitive impairment,and there was significant difference in statistics(P<0.05).【Conclusion】WML,MAT and LI were independent risk factors for mild cognitive impairment(P<0.05).If it can be prevented and treated,it will reduce the occurrence and development of vascular cognitive impairment to a large extent.
作者
严春梅
高曲文
YAN Chunmei;GAO Quwen(Department of VIP Ward,General Hospital of Southern Theater Command,PLA,Guangzhou,Guangdong 510010,China)
出处
《中国医学工程》
2020年第12期42-45,共4页
China Medical Engineering
关键词
脑血管障碍
认知障碍
危险因素
cerebrovascular disorders
cognition disorders
risk factors
