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目的探讨皮质下缺血性血管病患者额叶白质病变对认知功能的影响。方法回顾性收集2013年1月至2015年1月期间我科住院诊断为皮质下缺血性脑血管病患者121例,根据额叶白质病变程度,将皮质下缺血性脑血管病患者分为轻度(67例)和重度(54例)脑白质病变组。同时选择同年龄段60例健康、无认知障碍者为对照组;所有受试者均为右利手,且母语均为中文。对三组受试者进行神经心理量表测定,评估其认知功能、记忆功能及执行功能,并对额叶白质病变的程度与认知功能进行非参数等级相关分析。结果与轻度脑白质病变组和对照组相比,重度脑白质病变组的MMSE评分、AVLT评分、ROCF评分及Stroop评分明显降低,P值均<0.05。患者MMSE评分与脑白质病变损害严重程度呈正相关(R=0.933,P=0.013),即脑白质病变的严重程度与认知障碍程度呈正相关。结论皮质下缺血性脑血管病患者,额叶的脑白质主要累及认知功能、记忆功能及执行功能,且脑白质病变的严重程度与认知障碍程度呈正相关。
Objective To investigate the effect of frontal white matter lesions on cognitive function in patients with subcortical ischemic vascular disease. Methods Retrospectively collected 121 cases diagnosed as subcortical ischemic cerebrovascular disease from January 2013 to January 2015 in our department. According to the degree of frontal white matter disease, patients with subcortical ischemic cerebrovascular disease were divided into Mild (67 cases) and severe (54 cases) group of white matter lesions. At the same time select the same age group of 60 healthy, no cognitive impairment as a control group; all subjects are right hand, and the native language is Chinese. Neuropsychological tests were performed on three groups of subjects to assess their cognitive function, memory function and executive function. Non-parametric rank correlation analysis was performed between the degree of frontal white matter disease and cognitive function. Results The MMSE score, AVLT score, ROCF score and Stroop score of severe leucoencephalopathy group were significantly lower than those of mild group and control group (all P <0.05). There was a positive correlation between MMSE score and the severity of leukoencephalopathy (R = 0.933, P = 0.013), that is, the severity of leukoencephalopathy was positively correlated with the degree of cognitive impairment. Conclusion In patients with subcortical ischemic cerebrovascular disease, the frontal lobe white matter mainly involves cognitive function, memory function and executive function, and the severity of white matter lesion is positively correlated with the degree of cognitive impairment.