脑血管病患者认知功能改变与脑室线性结构的相关性研究

目的：探讨脑血管病患者认知功能改变与脑室线性结构的相关性，进一步探讨血管性认知障碍的临床特点。方法：采用CT／MRI技术测量脑梗死、腔隙性脑梗死、脑出血的病灶体积和脑室线性结构；应用简易精神状态智能量表，中国成人智力量表中的词义分辨项、数字背诵项；临床记忆量表中的图像自由回忆、无意义图形再认、人像特点联系回忆项，连线测验A、连线测验B组成的神经心理量表进行认知功能测定。结果：脑梗死组、腔隙性脑梗死组、脑出血组、健康对照组4组之间大多数认知功能无差异，仅在认知功能的回忆力分项中脑出血组与健康对照组之间有差异，脑出血组回忆力成绩低于健康对照组（P〈0．05）。患者哈氏值、脑室指数、前角指数、三脑室宽度与正常值比较差异均有统计学意义（P〈0．05）。哈氏值和三脑室宽度较正常值增大。脑室指数和前角指数较正常值减小。脑室指数与回忆力呈正相关（r=0．280，P〈0．05）。前角指数与MMSE总分、定向力、回忆力呈正相关（r=0．322、0．337、0．368，P〈0．05），与连线测验A和连线测验B所用时间呈负相关（r=-0．278、-0．334，P〈0．05）。结论：脑血管病可引起认知功能下降。脑血管病患者存在不同程度的脑萎缩，尤以额叶皮质和皮质下深部白质的萎缩明显。

Correlative Analysis of Changes for Cognitive Function and Cerebroventricular Linear Structure of Patients with Cerebrovascular Disease

Aim ： To study the correlation of changes for cognitive function and cerebroventricular linear structure of patients with cerebrovascular disease, and to further study the clinical feature of vascular cognitive functional impairment. Methods： Apply CT/MRI technique to measure volume and cerebroventricular linear structure of 18 cases of patients with cerebral infarction,27cases of patients with lacunar infarction,11 cases of patients with cerebral hemorrhage, to make use of items of words resolution and figure reciting in mini-mental state examination and China adult intelligence scale, image free recall,nonsense figure recognition and portrait feature associated recall in clinic memory scale, trail making test A and B in neural mental scale to determine cognitive function of three groups of patients and 13 cases of health people. Results ： There was no difference in most of cognitive function among groups of cerebral infarction,lacunar infarction, cerebral hemorrhage and control, only results of reminiscence of cognitive function for cerebral hemorrhage groups were lower than for control groups（P〈0.05）. Sound value, cerebroventricular and anterior angle indexes and width of the third encephalocoele of patients were different from the normal value（P〈0.05）. Sound value and width of the third encephalocoele were larger than the normal value while cerebroventricular and anterior angle indexes were lower than the normal value. Cerebroventricular index was positive correlation to reminiscence（r= 0.280, P〈0.05）. Anterior angle index was positive correlation to MMSE results and orientation force and reminiscence（r=-0.322, 0.337, 0.368, P〈0.05）, while it was negative correlation to time of trail making test A and B（r=-0.278, -0.334, P〈0.05）. Conclusion： Cerebrovascular disease could descend cognitive function. Patients with cerebrovascular disease had encephalanalosis to some extent, atrophy of the cortex of frontal lobe and the deep white matter of subcortex was obvious.