无症状性脑梗死对首发急性缺血性卒中患者认知功能的影响

目的 观察无症状性脑梗死(silent cerebral infarction,SCI)对首发急性缺血性卒中患者认知功能的影响.方法 连续纳入起病14 d内的首发急性缺血性卒中患者,依据MRI将患者分为急性缺血性卒中伴随SCI和不伴随SCI两组.认知功能评定采用北京版蒙特利尔认知评估(Montreal cognitive assessment,MoCA)量表和简明智力状态检查(mini-mental state examination,MMsE)量表,分别在卒中后2周及3个月进行.结果 急性缺血性卒中早期和3个月,SCI组与非SCI组非痴呆性血管性认知功能损害比例分别为(54.7%、76.4%;54.1%、66.7%),血管性痴呆比例分别为(28.3%、11.8%;13.5%、7.4%),MoCA评分中位数分别为(19、22;22、25),P值均>0.05;SCI病灶数量是卒中后3个月痴呆的危险因素(OR=1.22,95% CI 1.02～1.45):卒中后3个月SCI组总体认知功能及视空间执行功能、注意力和抽象思维能力无显著改善,P值均>0.05.结论 SCI病灶数量是首发急性缺血性卒中后3个月痴呆的危险因素,SCI影响患者认知功能的改善.

Effects of silent cerebral infarction on cognitive function in patients with first-ever acute ischemic stroke

Objective To prospectively investigate the influence of silent cerebral infarction(SCI) on cognition outcome of first ever acute ischemic stroke patients.Methods Patients with first-ever acute ischemic stroke in 14 days were consecutive recruited.All patients completed MRI brain scan and the results were reviewed blindly by two neurology physicians.According to MRI,the patients were divided into 2 groups: acute ischemic stroke patients with SCI and those without SCI.The cognitive state was evaluated by Chin...