短暂性脑缺血发作患者认知功能特点及动态观察

目的观察前循环短暂性脑缺血发作(TIA)后认知功能障碍的特点及动态变化。方法纳入2017年8月至2018年8月于河南省人民医院神经内科住院的前循环TIA病人82例(TIA组),均行头颅磁共振灌注成像(PWI)检查。采用蒙特利尔认知评估量表(Mo CA)对其分别在发病后的第7天、第1个月±3天、第3个月±5天、第6个月±7天进行认知及运动功能评估,并与90例正常体检者(正常对照组)对照。结果发病后4个时间点分别有46例(60. 5%)、48例(63. 1. 0%)、60例(78. 9%)和65例(85. 5%) TIA患者存在认知功能损害。TIA组发病后第1个月、第3个月、第6个月,Mo CA总分逐渐下降(P 0. 05),且各时间点Mo CA总分均较正常对照组低,差异具有统计学意义(P 0. 05); MoCA各因子中,视空间与执行能力、延迟回忆、语言重复、语言流畅性等分项评分明显下降,差异有统计学意义(P 0. 05)。结论 TIA发病早期即可出现认知障碍,且持续存在,发病3个月后认知功能明显下降。

Features and dynamic changes of cognitive function in patients with transient ischemicattack

Objective To investigate the features and dynamic changes of cognitive impairment after anterior circulation transient ischemic attack (TIA).Methods A total of 82 patients with anterior circulation TIA who were hospitalized in Department of Neurology, Henan Provincial People's Hospital, from August 2017 to August 2018 were enrolled as TIA group, and all of them underwent cranial perfusion-weighted imaging (PWI). Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive and motor function on day 7 and at 1 month±3 days, 3 months±53 days, and 6 months±7 days after disease onset. A total of 90 individuals who underwent physical examination were enrolled as normal control group.Results At the above four time points after disease onset, there were 46 (60.5%), 48 (63.1.0%), 60 (78.9%), and 65TIA patients (85.5%) with cognitive impairment, respectively. The TIA group had a gradual reduction in total MoCA score from month 1 to month 6 after disease onset (P<0.05), and the TIA group had a significantly lower total MoCA score than the normal control group at each time point (P<0.05). As for the domains of MoCA, the TIA group had significant reductions in the scores of visual space and executive ability, delayed recalls, language repetition, and verbal fluency (P<0.05).Conclusions Cognitive impairment may occur in the early stage of TIAand continue to exist, and cognitive function is significantly reduced at 3 months after the onset of TIA.