急性缺血性卒中抑郁-执行功能障碍综合征与胆碱能通路白质病变的关系研究

目的 探讨急性缺血性卒中抑郁-执行功能障碍综合征 （depression-executive dysfunction syndrome， DES） 与胆碱能通路上白质病变的关系。方法 连续入组急性缺血性卒中患者119例， 完善头颅磁共振成像检查， 有抑郁且有执行功能障碍的患者为抑郁-执行功能障碍综合征组， 其余的入组对象为非抑郁-执行功能障碍综合征组， 用胆碱能通路白质病变量表 （cholinergic pathways hyperintensities scale， CHIPS） 评估2组胆碱能通路上的白质病变。结果 抑郁-执行功能障碍综合征组较非抑郁-执行功能障碍综合征组胆碱能通路上白质病变的 CHIPS总分显著增高 （ P =0.033） ， CHIPS评分中的高外囊层面白质病变的评分也显著增高 （ P =0.017） 。结论 抑郁-执行功能障碍综合征与胆碱能通路上白质病变有关， 胆碱能通路上白质病变的损伤可能为DES的发病机制。

Study on the Relationship between Depression - executive Dysfunction Syndrome after Acute Ischemic Stroke and White Matter Lesions within Cholinergic Pathways

Objective To investigate the relationship between the depression-executive dysfunction syndrome(DES) after acute ischemic stroke and white matter lesions within cholinergic pathways cholinergic pathway using the cholinergic pathways hyperintensities scale(CHIPS) to rate the white matter lesions within cholinergic pathways. Methods One hundred and nineteen patients with acute ischemic stroke were recruited, which were divided into depression-executive dysfunction syndrome group and non-depressed-executive dysfunction syndrome group. All of them had a brain magnetic resonance imaging(MRI) scan, and white matter lesion on brain MRI was evaluated with the CHIPS. Results The total CHIPS scores in DES group increased significantly compared with non-DES group ( P =0.033), and the CHIPS scores in white matter lesion of high external capsule horizon in DES group increased significantly compared with non-DES group ( P =0.017). Conclusion DES after acute ischemic stroke had a strong relationship with white matter lesion within cholinergic pathways, and white matter lesion within cholinergic pathways may lead to DES.