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目的:研究皮质下缺血性脑血管病(SIVD)患者认知功能损害的特点。方法:选择2011年7月?2012年9月就诊于哈尔滨医科大学第二附属医院门诊及住院患者,颅脑MRI影像学显示脑白质疏松患者49例为LA组,按照Abaron-peretz标准将LA组进一步分为4组;MRI表现为腔隙性脑梗死(LACI)患者为腔隙性脑梗死组,共30例;选择年龄、性别匹配的30例健康老年人为对照组。采用蒙特利尔认知评估量表(MoCA)对各组患者进行神经心理学测评,分析各组受损的认知领域。结果:1)LA各级别组间总体认知功能及延迟回忆比较差异显著(P<0.05);与1组、2组、3组比较,4组患者视空间/执行能力得分显著下降差异具有统计学意义(p<0.05)。2)与正常组相比LA组及LACI组患者总体认知评分降低;与LACI组比较,LA组延迟回忆评分以及视空间/执行、注意力评分均显著降低差异均具有统计学意义(P<0.05)。结论:SIVD患者同时存在多个认知域损害,以执行功能、视空间结构损害和注意力较为突出,同时存在记忆力损害。SIVD患者中腔隙性脑梗死患者视空间/执行能力及注意力损害为主,而LA患者则记忆力损害更为明显。
Objective: To study the characteristics of cognitive impairment in patients with subcortical ischemic cerebrovascular disease (SIVD). Methods: From July 2011 to September 2012, 49 outpatients and inpatients with Second Affiliated Hospital of Harbin Medical University were enrolled in this study. 49 patients with cerebral white matter were selected as LA group by brain MRI. According to Abaron-peretz standard, LA group Thirty patients with lacunar infarction were enrolled in this study. Thirty patients with lacunar infarction (LACI) were selected as lacunar infarcts. Thirty healthy controls were selected as controls. Neuropsychological assessment of each group was performed using the Montreal Cognitive Assessment Scale (MoCA), and the impaired cognitive domains of each group were analyzed. Results: 1) There was significant difference in overall cognitive function and delayed memory between LA groups (P <0.05). Compared with group 1, group 2 and group 3, the scores of visual acuity / executive ability decreased significantly in 4 groups Significance (p <0.05). 2) Compared with normal group, the overall cognitive score of LA group and LACI group decreased. Compared with LACI group, LA group delayed recall score and visual acuity / executive and attention score decreased significantly (P < 0.05). Conclusion: There are multiple Cognitive Domain Damage (SIVD) in SIVD patients, and their function and visual structure damage and attention are more prominent. At the same time, there is memory impairment. Patients with lacunar infarction in SIVD had a predominantly spatial / executive capacity and impairment of attention, whereas memory impairment was more pronounced in LA patients.