本文選題：輕度認知功能障礙　切入點：腦小血管閉塞　出處：《內(nèi)蒙古民族大學(xué)》2017年碩士論文

【摘要】：目的:對急性腦小血管閉塞(Small artery occlusion,SAO)致輕度認知功能障礙(Mild cognitive impairment,MCI)的相關(guān)危險因素進行單因素及多因素分析,探究可能延緩認知功能障礙發(fā)生的可控因素。方法:收集2015年11月至2016年11月就診于內(nèi)蒙古民族大學(xué)附屬醫(yī)院的神經(jīng)內(nèi)科門診、住院部的急性SAO患者,通過簡易精神狀態(tài)評估量表和蒙特利爾認知評估(Montreal cognitive assessment,Mo CA)量表對患者進行分組,MCI組60例,非認知功能障礙(No cognitive impairment,NCI)組59例。對入選患者的一般臨床情況資料、實驗室生化指標(biāo)、頸動脈超聲情況、頭顱MRI病灶數(shù)量和部位進行記錄。通過SPSS 22.0統(tǒng)計學(xué)軟件包對MCI組和NCI組記錄資料進行相關(guān)危險因素的分析。結(jié)果:1.單因素分析,MCI組與NCI組比較高血壓病、糖尿病、高脂血癥、年齡、Mo CA評分、甘油三酯、血肌酐、纖維蛋白原差異有統(tǒng)計學(xué)意義(p0.05);2.多因素分析,高脂血癥可能為急性SAO致MCI的獨立危險因素;3.MCI組和NCI組小學(xué)及其以下與中學(xué)及其以上Mo CA評分比較差異均有統(tǒng)計學(xué)意義(p0.05),MCI組文化程度與Mo CA評分呈正相關(guān)(r=0.460),差異有統(tǒng)計學(xué)意義(p0.01);4.MCI組與NCI組比較,頸總動脈處斑塊發(fā)生率差異有統(tǒng)計學(xué)意義(p=0.012),頸動脈內(nèi)中膜增厚及斑塊發(fā)生情況差異無統(tǒng)計學(xué)意義(p0.05),頸動脈單側(cè)、雙側(cè)、分叉處、頸內(nèi)動脈的斑塊發(fā)生率差異無統(tǒng)計學(xué)意義(p0.05);5.MCI組與NCI組比較,病灶右側(cè)、雙側(cè)分布差異有統(tǒng)計學(xué)意義,病灶單發(fā)、多發(fā)、左側(cè)分布差異無統(tǒng)計學(xué)意義;6.兩組頭顱MRI病灶數(shù)量比較差異有統(tǒng)計學(xué)意義(p=0.002),腦橋、側(cè)腦室旁病灶發(fā)生比較差異有統(tǒng)計學(xué)意義(p0.05),延髓、小腦、丘腦、基底節(jié)區(qū)、半卵圓中心、額區(qū)、頂枕區(qū)、顳區(qū)病灶發(fā)生比較無統(tǒng)計學(xué)差異(p0.05)。結(jié)論:年齡、高血壓病、糖尿病、高脂血癥、甘油三酯、血肌酐、纖維蛋白原可能是急性SAO致MCI的相關(guān)危險因素,高脂血癥可能是其獨立危險因素,文化程度、頸動脈斑塊發(fā)生部位可能與急性SAO致MCI有關(guān),腔隙性腦梗死的病灶分布、部位和數(shù)量可能與急性SAO致MCI有關(guān)。
[Abstract]:Objective: to investigate the risk factors associated with mild cognitive impairment (mild cognitive impaction) in patients with acute small artery occlusion (SAO). Methods: from November 2015 to November 2016, we collected patients with acute SAO in the Department of Neurology, Department of Neurology, affiliated Hospital of Inner Mongolia University for nationalities, from November 2015 to November 2016. The patients were divided into MCI group (n = 60) and no cognitive impairment group (n = 59). The general clinical data and laboratory biochemical indexes were analyzed. Carotid ultrasound, the number and location of head MRI lesions were recorded. The data of MCI and NCI were analyzed by SPSS 22.0 statistical software package. Results 1. Univariate analysis showed that hypertension was compared between MCI group and NCI group. Diabetes mellitus, hyperlipidemia, age Mo CA score, triglyceride, serum creatinine, fibrinogen were significantly different. The independent risk factors of hyperlipidemia may be MCI caused by acute SAO. 3. There are significant differences in the scores of Mo CA between primary school and middle school and middle school in MCI group and NCI group. There is a positive correlation between education level and Mo CA score in MCI group and NCI group, and there is a positive correlation between the educational level of MCI group and Mo CA score, and the difference is significant. There was significant difference between MCI group and NCI group. There was significant difference in the incidence of plaque in common carotid artery (P 0.012). There was no significant difference in carotid intima media thickening and plaque occurrence (P 0.05). The carotid artery was unilateral, bilateral and forked. There was no significant difference in plaque incidence of internal carotid artery between MCI group and NCI group. There were significant differences in the distribution of right and bilateral lesions between MCI group and NCI group. There was no significant difference in the number of brain MRI lesions between the two groups. There were significant differences in the number of brain MRI lesions between the two groups. There were significant differences in p0. 05, medulla, cerebellum, thalamus, basal ganglia region, center of semiovale, pons and paraventricular lesions. Conclusion: age, hypertension, diabetes mellitus, hyperlipidemia, triglyceride, serum creatinine and fibrinogen may be the risk factors of acute SAO induced MCI. Hyperlipidemia may be an independent risk factor, education level, carotid plaque location may be associated with acute SAO induced MCI, lacunar cerebral infarction focus distribution, location and number of acute SAO may be related to MCI.
【學(xué)位授予單位】：內(nèi)蒙古民族大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

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