本文選題：腦白質(zhì)病變 + 認(rèn)知��； 參考：《山東大學(xué)》2014年碩士論文

【摘要】：研究目的： 研究不同程度、不同部位的腦白質(zhì)病變(white matter lesions,WML)對患者認(rèn)知功能的影響,并探究伴有腔隙性腦梗死的白質(zhì)病變患者的認(rèn)知功能的特點,對預(yù)測腦卒中、癡呆、日常生活能力的下降有重要價值。 研究方法： 選取于2013年11月至2014年1月在省立醫(yī)院神經(jīng)內(nèi)科門診及住院就診的腦白質(zhì)病變患者96例和正常對照組20例。采集臨床資料,并根據(jù)顱腦MRI的T2加權(quán)像、Flair像,根據(jù)病變的嚴(yán)重程度,將WML組分為單純WML組70例(采用Fazekas等級視覺評分方法又分為,輕度亞組30例,中度亞組20例,重度亞組20例)和WML伴有腔隙性腦梗死(silent lacunar infarcts,LI)組26例。 根據(jù)白質(zhì)病變累及的部位,將單純WML組分為室周旁白質(zhì)病(periventricular lesions, PVL)亞組39例和皮層下深部白質(zhì)病變(deep white matter lesions, DWML)亞組31例。應(yīng)用簡明精神狀態(tài)檢查表(MMSE)、蒙特利爾認(rèn)知功能評估量表(MoCA)、日常生活能力量表(ADL)對所有入選對象進行認(rèn)知評估。 研究結(jié)果： (1)WML中、重度亞組簡易精神狀態(tài)檢查表(MMSE)及蒙特利爾認(rèn)知評估量表(MoCA)評分顯著低于WML輕度亞組和對照組(P0.05)；WML輕度亞組與對照組僅在MoCA總分、視空間與執(zhí)行功能得分有統(tǒng)計學(xué)差異；WML重度亞組在視空間與執(zhí)行功能、語言功能、抽象能力、延遲回憶、注意力與計算力得分較WML中度亞組得分較低(P0.05)。 (2)皮層下深部白質(zhì)病變組MoCA總分、視空間與執(zhí)行功能比室周旁白質(zhì)病變組得分較低,而MMSE總分、語言能力、定向力、注意力與計算力、抽象能力、延遲回憶得分差異無統(tǒng)計學(xué)意義。 (3)與單純WML組相比,WML-LI組MMSE、MoCA,總分、視空間與執(zhí)行功能、語言功能、抽象能力、延遲回憶、定向能力、注意力與計算力得分均有顯著降低(P0.05)。 研究結(jié)論： (1)白質(zhì)病變到一定程度才會引起認(rèn)知功能減退；隨著白質(zhì)病變程度越重,患者認(rèn)知下降越顯著。 (2)室周旁白質(zhì)病變和深部白質(zhì)病變對認(rèn)知的影響可能不同。皮層下深部腦白質(zhì)病變對認(rèn)知功能的影響較室周旁腦白質(zhì)病變明顯,尤其在視空間與執(zhí)行功能。 (3)合并腔隙性腦梗死(WML-LI)組患者相較對照組和WML組,認(rèn)知功能更容易受損。
[Abstract]:Objectives of the study:To study the effects of white matter lesions (WMLs) on cognitive function in patients with white matter lesions, and to explore the characteristics of cognitive function in patients with lacunar infarction.The decline in daily life is of great value.Research methods:From November 2013 to January 2014, 96 patients with leukoencephalopathy and 20 normal controls were selected from Department of Neurology, Department of Neurology, Provincial Hospital.The clinical data were collected. According to the T2-weighted flair images of craniocerebral MRI, the WML group was divided into simple WML group (70 cases) according to the severity of the lesion (30 cases of mild subgroup, 20 cases of moderate subgroup, 30 cases of mild subgroup and 20 cases of moderate subgroup).In severe subgroup (n = 20) and in WML group (n = 26), silent lacunar silent lacunar with lacunar infarction (n = 26).According to the location of white matter lesion, the WML group was divided into three groups: periventricular leukopathy (PVL) group (n = 39) and deep subcortical white matter lesion (WML) subgroup (n = 31).All the subjects were evaluated with MMSE, MMSE, MoCAA and ADL.Results of the study:The scores of MMSE and MMA in severe subgroup were significantly lower than those in WML mild subgroup and control group (P 0.05) and only in the total score of MoCA.The scores of visual space and executive function were statistically different. The scores of visual space and executive function, language function, abstract ability, delayed recall, attention and computational ability were lower than those of WML moderate subgroup (P 0.05).(2) the total score of MoCA, visual space and executive function in deep subcortical white matter lesion group was lower than that in periventricular white matter lesion group, while the total score of MMSE, language ability, orientation, attention and computational ability, abstract ability, and so on.There was no significant difference in delayed recall scores.Compared with WML group, the total score, visual space and executive function, language function, abstract ability, delayed recall, directional ability, attention and computational ability in WML-LI group decreased significantly (P 0.05).The study concluded that:1) leukoencephalopathy caused cognitive impairment to a certain extent, and with the severity of leukoencephalopathy, the cognitive decline was more significant.2) the effects of periventricular white matter lesion and deep white matter lesion on cognition may be different.The effect of deep subcortical white matter lesion on cognitive function was more obvious than that on paraventricular white matter lesion, especially in visual space and executive function.3) the cognitive function of patients with lacunar infarction (WML-LI) group was more easily impaired than that of control group and WML group.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R742

【參考文獻】

相關(guān)期刊論文 前3條

1 郭洪志;腦白質(zhì)疏松癥[J];臨床神經(jīng)病學(xué)雜志;2002年01期

2 何燕玲,張明園,李柔冰;老人日常生活活動能力的變化及與癡呆的關(guān)系[J];中國臨床心理學(xué)雜志;1998年01期

3 雷立存;杜亞強;何麗;王偉秀;武延華;郭欣珊;;深部腦白質(zhì)缺血與輕度認(rèn)知功能障礙MR擴散張量成像的相關(guān)性[J];中國醫(yī)學(xué)影像學(xué)雜志;2013年10期

，

本文編號：1749741