《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (7): 651-655.

• 论文 • 上一篇    下一篇

大脑中动脉供血区不同梗死灶所致认知障碍的特点

张卫,恽晓平,于一宁   

  1. 1. 太原市中心医院康复医学科,山西太原市030009;2.首都医科大学康复医学院,北京市100068;3.中国康复研究中心北京博爱医院康复评定科,北京市100068。
  • 收稿日期:2014-06-11 修回日期:2014-06-30 出版日期:2014-07-25 发布日期:2014-07-25
  • 通讯作者: 恽晓平

Correlation of Cognitive Impairment and Areas of Middle Cerebral Artery Territory Infarction

ZHANG Wei, YUN Xiao-ping, YU Yi-ning.   

  1. Department of Rehabilitation, Taiyuan City Centre Hospital, Taiyuan, Shanxi 030009, China
  • Received:2014-06-11 Revised:2014-06-30 Published:2014-07-25 Online:2014-07-25

摘要: 目的从大脑中动脉供血区角度探讨不同梗死部位缺血性卒中与认知障碍之间的关系。方法应用蒙特利尔认知评估量表(MoCA)北京版,对首次急性发病2 周左右的缺血性卒中患者进行认知功能评估,记录其MoCA评分及各单项认知领域评分。按照大脑中动脉供血区梗死,MoCA评分≥15 分,且至少有一个认知领域障碍的条件,筛选出132 例患者资料。再按梗死部位分组, 将各组MoCA 结果进行相关分析。结果大脑中动脉供血区梗死与视空间/执行、注意、语言和记忆损害有关(B=-1.875~-1.094, P<0.05)。额叶梗死与视空间/执行、注意、抽象和记忆功能损害有关(B=-1.760~-1.329, P<0.05);颞叶梗死引起视空间/执行和记忆功能损害显著(B=- 1.849~- 1.735, P<0.05); 顶叶梗死导致视空间/执行、注意和记忆功能损害(B=-1.695~-1.482, P<0.05);基底节梗死与视空间/执行、注意、语言和记忆功能损害有关(B=-1.932~-1.041, P<0.01)。结论大脑中动脉不同供血区梗死所致认知功能损害的领域不同。

关键词: 缺血性卒中, 蒙特利尔认知评估量表, 认知障碍

Abstract: Objective To explore the correlation of cognitive impairment and areas of middle cerebral artery (MCA) territory infarction.Methods The Montreal Cognitive Assessment (MoCA) was used to evaluate neuropsychological statuses in the patients who developed first-time acute cerebral infarction for 2 weeks. MoCA scores and sub-scores were recorded. 132 patients were selected with MCA occlusion,scores of MoCA were more than 15, and cognitive impairment in at least one domain, and then subgrouped by infarction site. The correlation between the results of neuropsychological cognitive assessment and the sites of infarction was analyzed. Results MCA occlusion was correlated with the impairments of visual spatial/executive, attention, language and memory (B=-1.875~-1.094, P<0.05). Infarction in frontal lobe was correlated with the impairments of visual spatial/executive, attention, abstract and memory (B=-1.760~-1.329, P<0.05),temporal lobe with visual spatial/executive and memory impairment (B=-1.849~-1.735, P<0.05), parietal lobe with visual spatial/executive, attention and memory impairment (B=-1.695~-1.482, P<0.05), basal ganglia with visual spatial/executive, attention, language and memory impairment (B=-1.932~-1.041, P<0.01). Conclusion The characteristics of impairment in cognitive function is different with infarction sites in MCA territory.

Key words: ischemic stroke, Montreal Cognitive Assessment, cognitive impairment