脑白质病变合并静止性腔隙性脑梗死患者认知功能的变化

目的 探讨脑小血管病变（small vessel disease，SVD）患者认知功能障碍的特点。方法 临床收集136例患者和22名正常对照人群，根据MRI T2加权像和FLAIR像将病例组分为单纯（white matter le-sions，WML）组、单纯（silent lacunar infarction，SLI）组和WML合并SLI组，分别进行简明精神状态量表（mini-mental state examination，MMSE）、积木测验和画钟测验。结果 （1）单纯SLI组和WML合并SLI组患者的MMSE和积木测验评分均明显低于对照组（P〈0.01），单纯WML组、单纯SLI组和WML合并SLI组患者的画钟测验评分明显低于对照组；（2）与对照组比较，单纯WML组患者MMSE各项评分无明显下降；单纯SLI组患者注意计算、短程记忆、图形描画评分显著降低；WML合并SLI组患者时间定向、注意计算、短程记忆、语言理解和图形描画评分显著降低。结论 （1）脑小血管病变，尤其是WML合并SLI时，可导致认知功能下降；（2）WML合并SLI组患者主要表现为执行功能、视空间功能、注意计算、短程记忆等认知方面的障碍。

The change of cognitive function in the patients with both white matter lesion and silent lacunar infarction

Objective To investigate the change of cognitive function in the patients with both white matter lesion(WML)and silent lacunar infarction(SLI).Methods 136 patients were classified into group with pure WML,group with pure SLI and group with both WML and SLI according to MRI T2 images and FLAIR images,normal person as contrd group.All subjects' cognitive status were assessed with MMSE,block-test,clock-drawing test.Results Scores of MMSE and block-test in group with pure SLI and in group with both SLI and WML were lower than those in control group.Scores of clock-drawing test in all three patients' groups were lower than those in control group.Compared with control group,the patients in group with pure WML didn't have significantly low scores in MMSE,but the patients in group with pure SLI had significantly lower score in attention,calculation,short memory.Conclusions Cerebral small vessel disease will lead to cognitive decline especially in patients with both WML and SLI.In patients with both WML and SLI,cognitive declines such as executive function,visual-spatial function,attention,calculation,memory is more popular.