脑微出血患者认知功能变化的临床观察

目的探讨脑微出血（cerebralmicrobleeds，CMBs）与认知功能变化之间的关系及CMBs引起认知功能障碍的可能机制。方法以头颅MR磁敏感加权成像（susceptibilityweightedimagine，SWI）技术见脑微出血灶者为病例组共68例，选取头颅SWI序列未见微出血灶患者68例符合入选标准者作为对照组，两组同时运用蒙特利尔认知评估量表（MoCA）、画钟试验（CDT）进行评估。结果CMBs组的CDT分值（2．00±0．88）分]明显低于对照组（3．76±0．53）分]，且差异有统计学意义（t=-3．27，P=0．00）。CMBs组的MoCA总分及执行功能、命名、计算、语言、概括抽象、记忆评分均明显低于对照组，且差异有统计学意义（t=-5．48，P=0．00；t=-4．36，P=0．00；t=-2．35，P=0．01；t=-2．49，P=O．02；t=-4．09，P=O．00；t=-4．63，P=0．00）；CMBs轻度、中度、重度组CDT分值、MoCA总分、执行功能、语言、抽象概括、记忆评分与对照组比较差异均有统计学意义（P〈O．05），CMBs轻度组、中度组、重度组语言、计算及执行功能（CDT反映）得分组间差异有统计学意义（P〈0．05）。CMBs数目与总分、执行功能、语言、抽象概括呈负相关（r=-0．675，P=0．000；r=-0．689，P=0．000；r=-0．536，P=0．000；r=-0．636，P=0．ooo）。结论CMBs是否存在及数目多少和患者认知功能损害密切相关，CMBs数目越多，认知功能损害越明显。

Clinical observation on changes of cognitive function in patients with cerebral microbleeds

Objective To investigate the relationship between the cerebral microbleeds （CMBs） and changes of cognitive function, and the possible mechanism of cognitive impairment caused by CMBs. Meth- ods Sixty-eight micro-hemorrhage patients on susceptibility weighted imagine （SWI） sequences composed posi- tive group, and sixty-eight patients selected without micro-hemorrhage in the SWI sequence and meeting the selec- tion criteria as control group. At the same time, both two groups were assessed by MoCA and CDT scale inspection. Results CDT scores of CMBs group （2.00±0.88） were significantly lower than those of control group （3.76± 0.53） , and there was significantly different in the two groups （ t=-3.27, P= 0.00）. At the same time, MoCA total scores and executive functions, naming, calculation,language, abstraction, recall scores of CMBs group were signifi- cantly lower than those of control group, and all of the groups were significantly different （ t=-5.48, P= 0.00; t=-4.36, P=0.00; t=-2.35, P=0.01 ; t=-2.49, P=0.02; t=-4.09, P=0.00; t=-4.63, P= 0.00）. CDT seores,Mo- CA total scores, executive functions,language, abstraction, memory scores between CMBs groups and control group were significantly different at all levels （P〈 0.05）. Executive functions , languages and calculated inter-group of mild CMBs ,moderate CMBs, severe CMBs were significantly different （P〈0.05）. The number of CMBs was nega- tive correlation with total scores, executive function, language, and abstract （ r= -0.675, P= 0.000; r= -0.689, P= 0.000; r=-0.536, P= 0.000; r=-0.636, P= 0.000）. Conclusion The existence of CMBs and the number of CMBs are closely related to cognitive dysfunction. The more of CMBs, the more of obvious cognitive impairment.