皮质下缺血性血管性认知损害患者注意功能障碍的临床研究

目的:观察皮质下缺血性血管性认知功能损害(SIVCI)患者注意亚型障碍的特征。方法:对30例非痴呆型SIVCI(SIVCIND)患者(SIVCIND组)、15例皮质下缺血性血管性痴呆(SIVD)患者(SIVD组)和15名健康志愿者(对照组)采用计算机上持续操作任务(CPT)、Stroop试验及双任务测试法测试持续注意、选择注意和分散注意功能。结果:与对照组比较,SIVD组CPT反应时延长,漏报率增加(P<0.05);SIVCIND组漏报率与对照组比较显著增加,差异有显著统计学意义(P<0.01)。SIVD患者冲突及中性条件下,反应时与错误率及干扰量均增加;SIVCIND患者Stroop试验冲突条件反应时延长(P<0.01)、双任务法耗时差无明显增加(P>0.05);SIVD患者耗时差增加(P<0.01)。结论:SIVCIND早期主要以持续:注意及选择注意功能损害为主,晚期则持续注意、选择注意和分散注意功能普遍受累。

The Clinical Research of Attention Impairment in Patients with Subcortical Cognitive Impairment

Aim： To observe the characteristics of different subtype of attention impairment in patients with subcortical ischemic vascular cognitive impairment（SIVCI）. Methods： The subjects included 30 patients with vascular cognitive impairment no dementia（SIVC1ND）, 15 patients with subcortical ischemic vascular dementia （SIVD） and 15 control cases. Their function of sustained attention, selective attention and divided were tested by continuous performance task（CPT）, Stroop test and dual task test. Results：①Reaction time of CPT had significantly prolonged and omission rate of CPT had increased in SIVD group（P〈0.05） compared with the control group. Omission rate had increased in SIVCIND group（P〈0.01） compared with the control group. ② In Stroop test, reaction time under conflict condition had significantly prolonged（P〈0.01）, and error rate under conflict and neutral conditions had no significant increase（P〉0.05） in SIVCIND group compared with the control group. Reaction time, error rate and their interfered effect had obviously increased in SIVD group compared with the control group （P〈0.01）. ③SIVD group did worse in dual task than the control group （P〈0.01）. Conclusion： SIVCIND patients had predominance in sustained attention impairment completely and selective attention impairment partly. SIVD patients had general, obvious disorders in sustained attention, selective attention and divided attention.