本文選題：認(rèn)知功能 + 卒中�。� 參考：《浙江大學(xué)》2012年碩士論文

【摘要】：背景： 卒中后認(rèn)知損害為當(dāng)前研究熱點(diǎn),不同部位卒中引起的認(rèn)知改變模式仍在不斷探索和爭議中。腦卒中后除了有軀體功能缺損,往往還伴有認(rèn)知功能改變。以往認(rèn)為皮層為主要大腦功能結(jié)構(gòu)區(qū),但是近年來發(fā)現(xiàn)皮層下結(jié)構(gòu)也參與腦高級功能的形成。國內(nèi)外對丘腦及基底節(jié)區(qū)卒中后各認(rèn)知領(lǐng)域改變的研究仍較少。本課題擬從不同病灶部位認(rèn)知損害比較的角度研究皮層下關(guān)鍵部位丘腦及基底節(jié)區(qū)卒中的神經(jīng)心理特點(diǎn),為早期識別血管性認(rèn)知損害(VCI)患者提供依據(jù),也為卒中后康復(fù)措施的制定提供依據(jù)。 目的： 本課題使用成套神經(jīng)心理量表研究丘腦及基底節(jié)區(qū)卒中患者的認(rèn)知改變特點(diǎn),以推測皮層下結(jié)構(gòu)與大腦高級功能的關(guān)系。本課題的意義在于認(rèn)識非皮層結(jié)構(gòu)損害后腦高級功能的改變模式,推測大腦深部結(jié)構(gòu)的高級功能分化,從而在臨床上為建構(gòu)合理的VCI認(rèn)知評估提供實(shí)證依據(jù),同時(shí),也便于早期識別VCI患者,并進(jìn)行有效干預(yù)從而降低血管性癡呆(VaD)發(fā)病,減輕社會(huì)負(fù)擔(dān)。 方法： 2009年12月至2011年11月之間,連續(xù)收集浙江省嵊州市人民醫(yī)院神經(jīng)內(nèi)科門診和住院的丘腦或基底節(jié)區(qū)單病灶卒中病人88例為病例組做橫斷面研究(左側(cè)卒中41例,右側(cè)卒中47例),其中男性64例,女性24例。分為以下四組：左側(cè)丘腦卒中組(n=20)、右側(cè)丘腦卒中組(n=21)、左側(cè)基底節(jié)區(qū)卒中組(n=21)、右側(cè)基底節(jié)區(qū)卒中組(n=26)；并入選健康老人34名為正常對照組,其中男性27名,女性7名。以上研究對象年齡均在50～80歲,教育年限、性別、年齡和抑郁自評量表差異無統(tǒng)計(jì)學(xué)意義。全部對象均完成成套認(rèn)知功能檢查,包括總體認(rèn)知水平、記憶、語言、執(zhí)行、注意和空間功能等各個(gè)認(rèn)知領(lǐng)域。用SPSS11.5統(tǒng)計(jì)軟件對各組認(rèn)知指標(biāo)進(jìn)行分析。 結(jié)果： ①病例組與對照組比較：病例組在記憶功能、注意/執(zhí)行功能、語言功能、空間功能等存在廣泛的認(rèn)知損害,明顯差于對照組。②4組病例在相似性測驗(yàn)分析均有明顯下降,其中左側(cè)丘腦卒中組患者表現(xiàn)最差,左側(cè)丘腦卒中組和右側(cè)丘腦卒中組患者明顯差于左側(cè)基底節(jié)區(qū)卒中組和右側(cè)基底節(jié)區(qū)卒中組患者,說明相似性測驗(yàn)得分與左右丘腦關(guān)系密切。③左側(cè)丘腦卒中組和其他卒中組相比較：在言語功能、抑制干擾能力、信息處理速度和準(zhǔn)確性、聽覺詞語延遲回憶、注意/執(zhí)行功能、空間功能具有顯著差異,與其他3個(gè)卒中組患者相比,左側(cè)丘腦卒中組患者對認(rèn)知功能影響最嚴(yán)重。④左側(cè)基底節(jié)區(qū)卒中組和其他組比較：左側(cè)基底節(jié)區(qū)卒中組患者的特點(diǎn)是與右手操作相關(guān)的項(xiàng)目(如TMT、SDMT)表現(xiàn)優(yōu)于其他3個(gè)卒中組患者,而接近正常對照組。⑤右側(cè)基底節(jié)區(qū)卒中組和其他組比較：SCWT-C正確數(shù)右側(cè)基底節(jié)區(qū)卒中組患者表現(xiàn)最好,顯著優(yōu)于左側(cè)丘腦、左側(cè)基底節(jié)區(qū)卒中組患者,但與正常對照組比較,仍有明顯下降。 結(jié)論： ①丘腦、基底節(jié)區(qū)卒中患者的認(rèn)知損害較全面,包括記憶功能、執(zhí)行功能、注意功能、語言功能和空間功能都受到顯著影響,但損害模式各有不同,損害部位不同,認(rèn)知損害表現(xiàn)不同。②左側(cè)丘腦卒中患者的認(rèn)知損害相對最為嚴(yán)重。
[Abstract]:Background :

The cognitive impairment after stroke is the focus of the current research , and the cognitive change pattern caused by stroke in different parts is still being explored and disputed . In addition to the body function defect after stroke , the cognitive function change is often accompanied by the change of cognitive function . In recent years , it has been found that the subcortical structure is also involved in the formation of brain advanced function .

Purpose :

This topic uses a set of neuropsychological scales to study the cognitive changes of stroke patients in the thalamus and basal ganglia , so as to predict the relationship between the subcortical structure and the advanced function of the brain . The purpose of this project is to recognize the change pattern of the advanced function of the brain in the non - cortical structure , and to estimate the high - level functional differentiation of the deep brain structure . At the same time , it is convenient for early identification of VCI patients and effective intervention to reduce the incidence of vascular dementia ( VaD ) and reduce the social burden .

Method :

From December 2009 to November 2011 , 88 cases of single - focus stroke patients in Shengzhou People ' s Hospital of Zhejiang Province were collected continuously , including 64 males and 24 females , including 64 males and 24 females , including 64 males and 24 females , including the following four groups : left anterior cerebral stroke group ( n = 20 ) , right group stroke group ( n = 21 ) , left basal ganglia stroke group ( n = 21 ) , right basal ganglia stroke group ( n = 26 ) ;
All the subjects completed a complete set of cognitive functions , including overall cognitive level , memory , language , execution , attention and spatial functions .

Results :

Compared with the control group , there were significant differences in cognitive function between the right basal ganglia stroke group and the right basal ganglia stroke group .

Conclusion :

The cognitive impairment of stroke patients in thalamus and basal ganglia was more comprehensive , including memory function , executive function , attention function , language function and spatial function were significantly affected , but the damage pattern was different , the lesion site was different , and the cognitive impairment was different . 鈶，

本文編號：1953555