初次发病的腔隙性脑梗死患者急性期的认知改变

目的研究初次发病的腔隙性脑梗死患者在急性期的认知障碍特点。方法对91例初次发病的腔隙性脑梗死患者于发病1周内进行神经心理学测验，并与78名健康志愿者进行比较，观察不同认知域的变化特点。神经心理学测验包括简易精神状态检查量表、汉化的韦氏成人智力量表（数字广度、图片排列、数字符号和积木测验）、世界卫生组织一加利福尼亚洛杉矶大学听觉词语学习测验、简化的Rey复杂图形测验、Stroop测验、语义分类流畅性测验、加利福尼亚卡片分类测验和画钟测验。结果腔隙性脑梗死急性期患者在注意力、记忆力、执行能力和视空间结构能力等认知域评分均低于对照组，差异有统计学意义，P〈0．05；信息处理速度的评分与对照组比较，差异无统计学意义。结论初次发病的腔隙性脑梗死急性期的患者认知障碍广泛。腔隙性脑梗死后的认知障碍应作为临床特征，进行早期重视和干预。

Cognitive changes in patients with first attack lacunar infarction in the acute phase

Objective To study the characteristics of the cognitive impairment in patients with first attack lacunar infarction in the acute phase. Methods Neuropsychological tests were conducted for 91 patients with first attack of lacunar infarction within one week after the onset, and they were compared with 78 healthy volunteers. The characteristic changes of different cognitive domains were observed. Neuropsycho- logical tests included the mini-mental state examination, Chinese version of Wechsler adult intelligence scale （digit span, picture arrangement, digit sign and block test）, World Health Organization university of Califor- nia-Los Angeles auditory verbal learning test, Rey complex figure test, stroop test, semantic category verbal fluency test, California card sorting test, and clock drawing test. Results The cognitive domain scores, such as attention, memory, executive ability, and visuospatial and visuoconstructive abilities in patients with lacunar infarction in the acute phase were lower than those in the control group, and the difference was statis- tically significant （P 〈 0.05 ） ; the difference was not statistically significant in the scores of information pro- cessing speed as compared to that in the control group. Conclusion In patients with first attack of lacunar infarction, the cognitive impairment was extensive and severe in the acute phase. Cognitive impairment after lacunar infarction should be considered as a special clinical feature and pay early attention and intervention.