脑小血管病非痴呆患者脑微出血灶和认知功能关系的MRI研究

目的研究小血管病非痴呆患者脑微出血灶和认知功能关系的磁共振成像(MRI)。方法选取2012-01—2014-01我院接收治疗的小血管病非痴呆患者100例,对100例患者进行磁共振梯度回波T2加权成像检查。25例脑微出血阳性患者为观察组,75例脑微出血阴性患者随机选取25例为对照组。采用蒙特利尔认知评估量表(MoCA)、简易精神状态检查量表(MMSE)、画钟试验(CDT)对患者的认知功能进行评价。结果观察组患者的MoCA量表中命名、视空间执行、计算、语言、记忆和概括抽象均低于对照组,观察组MMSE量表和CDT量表评分均低于对照组,观察组脑白质损坏和腔隙性梗死灶数量显著高于对照组,差异具有统计学意义(P0.05)。2组患者的MoCA量表中注意和定向差异无统计学意义(P0.05)。Pearson偏相关分析结果显示脑微出血数量与注意力、视空间执行功能、计算能力呈负相关,与MoCA总分、CDT总分和MMSE总分呈正相关,与语言、命名、延迟记忆、定向力和抽象概括无相关性。结论脑小血管病非痴呆患者脑微出血灶数量与患者的认知功能障碍有一定的相关性,脑微出血灶数量越多,认知功能障碍越严重,可以将脑微出血灶的数量作为诊断早期血管性认知功能障碍的标准。

MRI study of the relationship between micro-hemorrhage and cognitive function in non-dementia CSVD patients

Objective To explore MRI study of the relationship between micro-hemorrhage and cognitive function in nondementia cerebral small vessel disease (CSVD) patients.Methods All of 100 cases with non-dementia CSVD in our hospital from January 2012 to January 2014 were examined by gradient-echo T2-weighted MRI.According to MRI results,25 cases with positive micro-hemorrhage were classified as observation group and 25 cases without micro-hemorrhage were identified as control group.We performed MoCA scale,MMSE and CDT to evaluate the cognitive function of two groups.Results The abilities of naming,visuospatial execution,calculation,language,memory and abstract generalization of MoCA scale as well as MMSE scores and CDT scores detected in the observation group were lower than that in the control group.On the contrary,patients with white matter damage and lacunar infarct observed in observation group were higher than those in control group with the statistical difference (P＜0.05).The attention ability and orientation capacity of MoCA scale showed no differences between two groups (P＞0.05).Pearson partial correlation analysis indicated that the number of micro-hemorrhage had positive correlation with attention ability,visuospatial executive function,calculation power,had negative correlation with total MoCA score,total CDT score and MMSE scores,and had no correlation with language,naming,delayed memory,disorientation and abstraction.Conclusion Cognitive function can be related to the number of intracerebral micro-hemorrhage in non-dementia CSVD patients;and with the more number of micro-hemorrhage,the cognitive dysfunction should be more severe.Thus,we should take the number of micro-hemorrhage into consideration as a criterion to diagnose the early cognitive dysfunction of CSVD.