【摘要】：目的:探討腔隙性腦梗死(LI)后合并非癡呆性血管性認(rèn)知障礙(VCIND)患者的臨床特點(diǎn)及認(rèn)知影響因素。方法:選擇2015年12月—2016年6月就診于新疆醫(yī)科大學(xué)第一附屬醫(yī)院的符合LI診斷標(biāo)準(zhǔn)的患者120例,參照認(rèn)知相關(guān)神經(jīng)量表進(jìn)行評(píng)分,篩選出LI中符合VCIND患者76例(VCIND組),在剩余患者中選擇認(rèn)知正常患者44例作為對(duì)照組(NC組),對(duì)兩組的年齡、性別、受教育年限、吸煙史、高血壓史、糖尿病史、高同型半胱氨酸血癥史、短暫性腦缺血發(fā)作(TIA)史、腦血管狹窄程度分級(jí)、腦白質(zhì)病變?cè)u(píng)分及認(rèn)知功能評(píng)分進(jìn)行比較,分析上述因素與LI后VCIND的關(guān)系。結(jié)果:兩組患者M(jìn)oCA量表子項(xiàng)進(jìn)行比較后在視空間及執(zhí)行功能、抽象能力、命名能力、注意力等方面存在差異(P0.05),且VCIND組以執(zhí)行功能、抽象能力、延遲回憶能力受損為主。對(duì)兩組患者的年齡、受教育時(shí)長(zhǎng)、高血壓史、精神狀態(tài)檢查量表(MMSE)評(píng)分、蒙特利爾認(rèn)知評(píng)估量表(MoCA)評(píng)分比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。NC組患者的腦血管狹窄程度分級(jí)、深部腦白質(zhì)評(píng)分均優(yōu)于VCIND組(P0.05)。進(jìn)行Logistic回歸分析后提示血管狹窄程度為3、4級(jí),深部腦白質(zhì)病變?cè)u(píng)分為3分是LI后VCIND的危險(xiǎn)因素,受教育時(shí)間長(zhǎng)是LI后VCIND的保護(hù)因素(P0.05)。結(jié)論:LI后VCIND患者的認(rèn)知功能在執(zhí)行能力、命名、注意、抽象能力、延遲回憶能力等方面存在損害,以執(zhí)行功能受損為主,腦血管狹窄程度中度以上和嚴(yán)重的深部腦白質(zhì)病變與LI后VCIND患者的認(rèn)知損害相關(guān)。
[Abstract]:Objective: to investigate the clinical features and cognitive influencing factors of patients with nondementia vascular cognitive impairment (VCIND) after lacunar cerebral infarction (LI). Methods: from December 2015 to June 2016, 120 patients who met the criteria of Li diagnosis in the first affiliated Hospital of Xinjiang Medical University were selected and scored according to the Cognitive related nerve scale. 76 patients (VCIND group) with Li and 44 patients with normal cognition were selected as control group (NC group). The age, sex, years of education, smoking history, hypertension history and diabetes history were compared between the two groups. The history of hyperhomocysteinemia, the history of transient ischemic attack (TIA), the grade of cerebral vascular stenosis, the score of leukoencephalopathy and the score of cognitive function were compared, and the relationship between the above factors and VCIND after Li was analyzed. Results: there were differences in visual space, executive function, abstract ability, naming ability and attention between the two groups after the comparison of sub-items of MoCA scale (P0.05), and the VCIND group was mainly impaired in executive function, abstract ability and delayed recall ability. There were significant differences in age, duration of education, history of hypertension, mental state examination scale (MMSE) and Montreal Cognitive Assessment scale (MoCA) between the two groups (P0.05). The white matter score of deep brain was better than that of VCIND group (P0.05). Logistic regression analysis showed that the degree of vascular stenosis was 3 grade 4, the score of deep white matter lesion 3 was the risk factor of VCIND after Li, and the long time of education was the protective factor of VCIND after Li (P0.05). Conclusion the cognitive function of patients with VCIND after VCIND was impaired in the aspects of executive ability, naming, attention, abstract ability, delayed recall, etc. Severe and moderate cerebral vascular stenosis was associated with cognitive impairment in patients with VCIND after Li.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R749.13

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