急性脑梗死后认知功能障碍的临床研究

目的 探讨并分析梗死灶部位与急性脑梗死(ACI)后认知功能障碍的关系.方法 选取134例ACI患者(ACI组)和100例健康人(对照组)进行简易精神状态检查表(MMSE)、临床记忆量表(CMS)、词语流畅性测验(VFT)、画钟测验(CDT)等评定,并行F300检查,将神经心理学量表评定结果及P300检查结果按照脑梗死的影像学分型进行对比研究.结果 1.中梗死与腔隙性梗死MMSE、CMS、VFT、CDT评分差异均有统计学意义(P<0.05或P<0.01);中梗死与小梗死、小梗死与腔隙性梗死之间MMSE、CMS、VFT、CDT评分差异均无统计学意义(P>0.05).2.中梗死及小梗死亚组示:额、颞叶梗死MMSE、CMS评分低于基底核区和顶、枕叶梗死,基底核区梗死MMSE、CMS评分低于顶、枕叶梗死,差异均有统计学意义(P<0.05或0.01);额叶梗死VFT、CDT评分明显低于颞、顶、枕叶和基底核区梗死,差异均有统计学意义(P<0.05或0.01).腔隙性梗死亚组示:额、颞、顶、枕、基底核区梗死之间比较MMSE、CMS、VFT、CDT评分差异均无统计学意义(P>0.05).结论 急性脑梗死后认知功能障碍与梗死灶部位密切相关.

Clinical research on cognitive function impairment after acute cerebral infarction

Objective To analyze the(ACI) relationship between infarction sites and cognitive impairment after acute cerebral infarction.Methods A total of 134 patients with first ACI and 50 healthy control subjects matched with age, sex and education level were selected.All subjects were assessed with mini-mental state examination (MMSE), clinical memory scale ( CMS), verbal fluency test ( VFT), clock drawing task ( CDT), Barthel index (B1) assessment,Haehinski ischemic scale (HIS), Hamilton depression scale (HAMD).All patients and healthy control subjects were examined with event-related potentials (ERP) P300 test.The relationship between Results of above-mentioned neuropsychological assessment and P300 findings were compared and analyzed in accordance with the neuroimaging type of cerebral infarction.Results 1.There was statistical significance in differences of scores of MMSE, CMS, VFT, CDT between middle infarction and lacunar infarction ( P < 0.05 or P < 0.01 ) ; There was no statistically significant difference in the scores of MMSE, CMS, VFT, CDT between middle infarction and small infarction, and between small infarction and lacunar infarction( P > 0.05 ).2.In middle infarction and small infarction subgroups: the scores of MMSE, CMS in frontal lobe infarction and temporal lobe infarction were lower than those in basal ganglia infarction, parietal lobe infarction and occipital lobe infarction; the scores of MMSE, CMS in basal ganglia infarction were lower than those in parietal lobe infarction and occipital lobe infarction, all had statistically significant differences( P < 0.05 or P < 0.01 ) ; the scores of VFT ,CDT in frontal lobe infarction were significantly lower than those in temporal lobe infarction, parietal lobe infarction, occipital lobe infarction and basal ganglia infarction, the difference had statistical significance( P < 0.05 or P < 0.01 ).3.In lacunar infarction subgroups: there was no statistically significant difference in scores of MMSE, CMS, VFT, CDT among frontal lobe infarction, temporal lobe infarction, parietal lobe infarction, occipital lobe infarction and basal ganglia infarction ( P >0.05 ).Conclusion The location of cerebral infarction is closely related with cognitive function impairment after ACI.