无症状性脑梗死患者智能障碍及相关因素研究

目的：探讨无症状性脑梗死（ACI）患者的智能障碍及相关因素。方法：用韦氏智力量表对经CT或MRI证实的56例ACI患者进行神经心理学检查，并与症状性脑梗死（SCI）组及正常对照组比较。对ACI病例中智能障碍组与非智能障碍组的梗死灶数量和部位、既往史及受教育程度进行对比分析。结果：36例ACI患者智力低于正常，其中13例出现智能障碍；ACI组分测验值与SCI比较无差异，但明显低于正常对照组；右侧梗死组中PIQ明显低于VIQ（P＜0．05）；智能障碍组受教育程度低、糖尿病史、多发性梗死、双侧梗死、颞叶梗死、侧脑室旁及丘脑梗死者与非智能障碍组相比有显著差异（P＜0．01－0．05）；智能障碍与文化程度呈负相关，与高血压病程呈正相关。结论：多发性梗死、双侧梗死、皮质及皮质下梗死与智能障碍发生密切相关，尤其是颞叶、侧脑室旁及丘脑梗死更易出现智能障碍；文化水平低、高血压、糖尿病是ACI智能障碍的危险因素。

Study on IntellectualImpairment of Asymptomatic Cerebral Infarction

Objective:To explore intellectual impairment and related factors in patients with asymptomatic cerebral infarction (ACI). Methods: Neuropsychological tests were administered to (a) 56 ACI patients identified by CT or MRI, (b) 50 patients with symptomatic cerebral infarction (SCI), and (c) 40 healthy control subjects. Correlation between intellectual impairment and sites of infarction, number of infarction, past history and educational levels was analyzed. Results: Levels of intelligence in 36 ACI cases were lower than normal, and among them 13 ACI cases had significant intellectual impairments. Test scores were found to be lower in the ACI patient group than in the healthy control group, which however did not differ significantly from the SCI control group. PIQ was found to be reduced significantly in patients with right cerebral infarction. Cases of low education level, diabetes, multiple cerebral infarction, bilateral cerebral infarction, temporal lobe infarction, thalamus infarction, and infarction adjacent to the lateral ventricle were more frequently identified in the intellectual impairment group as compared to the no impairment group (P<0.05～0.01). Intellectual impairment was negatively related to education, but positively related to history of hypertension. Conclusion: Multiple cerebral infarction, bilateral cerebral infarction, cortex infarction and thalamus infarction were commonly associated with intellectual impairment. Low education background, history of hypertension or diabetes might also constitute significant risk factors for intellectual impairment in patients of ACI.