摘要
目的探讨不同梗死病灶对急性脑梗死相关血管性痴呆的影响。方法选取2016年3月～2018年5月来我院神经内科和康复科就诊的急性脑梗死患者240例,分为认知正常组、无痴呆型血管性认知障碍(V-CIND)组和血管性痴呆(VaD)组。收集三组患者的基线资料、梗死病灶部位,采用MoCA量表比较认知正常组和VaD组的认知功能水平。结果共入选240例急性脑梗死患者。三组患者梗死部位在额叶、颞叶、顶叶、丘脑以及基底节的发生率比较,差异有统计学意义(P<0.05)。与认知正常组比较,VaD组患者梗死部位在额叶、颞叶、丘脑的发生率较高,在基底节的发生率较低(P<0.05);与V-CIND组比较,VaD组患者梗死部位在额叶、顶叶和基底节的发生率较低(P<0.05)。VaD组梗死部位在额叶的患者在视空间、命名、注意、语言以及抽象思维等方面的MoCA得分低于认知功能正常组(P<0.05);VaD组梗死部位在颞叶的患者在视空间、记忆、注意、以及抽象思维等方面MoCA得分低于认知功能正常组(P<0.05);VaD组梗死部位在丘脑、基底节和胼胝体的患者记忆等方面MoCA得分低于认知功能正常组(P<0.05)。结论急性脑梗死患者的不同梗死部位对认知功能障碍特点有所影响,梗死部位在额叶、颞叶、丘脑、基底节和胼胝体等部位时,易引发血管性痴呆。
Objective To investigate the effects of different infarct lesions on vascular dementia associated with acute cerebral infarction.Methods 240 patients with acute cerebral infarction treated in the department of neurology and rehabilitation of our hospital from March 2016 to May 2018 were selected and divided into cognitive normal group,vascular cognitive impairment no dementia(V-CIND)group,and vascular dementia(VaD)group.Baseline data and infarct sites were collected from three groups,and the cognitive function levels were compared between the cognitive normal group and the VaD group using the MoCA scale.Results A total of 240 patients with acute cerebral infarction were enrolled.The incidence of infarcts in the frontal lobe,temporal lobe,parietal lobe,thalamus and basal ganglia was different in the three groups(P<0.05).Compared with the normal cognitive group,the incidence of infarction in the frontal lobe,temporal lobe,and thalamus was higher in the VaD group,and the incidence in the basal ganglia was lower(P<0.05).Compared with the V-CIND group,the incidence of infarction in the frontal,parietal and basal ganglia was lower in the VaD group(P<0.05).The MoCA scores,including visual space,naming,attention,language,and abstract thinking,of patients with infarction in the frontal lobe in the VaD group were lower than those in the normal cognitive function group(P<0.05).The MoCA scores,including visual space,memory,attention,and abstract thinking,of patients with infarction in the temporal lobe in the VaD group were lower than those in the normal cognitive function group(P<0.05).The MoCA scores of memory of patients with infarction in the thalamus,basal ganglia and corpus callosum in the VaD group were lower than those in the normal cognitive function group(P<0.05).Conclusion Different infarct sites in patients with acute cerebral infarction have an effect on the characteristics of cognitive dysfunction.When the infarction site is in the frontal lobe,temporal lobe,thalamus,basal ganglia and corpus callosum,it is easy to cause vascular dementia.
作者
盛卫东
SHENG Weidong(Department of Rehabilitation,Nantong Third People's Hospital in Jiangsu Province,Nantong 226006,China)
出处
《中国现代医生》
2018年第35期15-18,共4页
China Modern Doctor
关键词
脑梗死
血管性认知障碍
血管性痴呆
梗死部位
Cerebral infarction
Vascular cognitive impairment
Vascular dementia
Infarction site
