论文部分内容阅读
目的探讨不同部位缺血性脑卒中急性期患者认知功能损害的特点。方法收集230例脑梗死急性期(1～14 d)患者,包括额叶31例,颞叶27例,顶叶26例,枕叶21例,基底节47例,丘脑35例,小脑23例,脑干20例;采用中文版蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)对受试者进行认知功能测评。结果 (1)各病变部位认知障碍的发生率不同;额叶组、颞叶组及丘脑组MoCA总分低于其他各组(P<0.05),顶叶组、枕叶组MoCA总分与基底节组、小脑组和脑干组比较有显著性差别(P<0.05);(2)额叶组在视空间及执行功能、注意认知域及MoCA总分值低于其他各组(P<0.05);颞叶组在命名、延迟回忆认知域分值低于其他各组,MoCA总分与顶叶组、枕叶组、基底节组、小脑组、脑干组有显著性差异(P<0.05);顶叶组及枕叶组MoCA总分低于基底节、小脑、脑干组(P<0.05);丘脑组在视空间及执行功能、注意认知域及MoCA总分低于顶叶、枕叶、基底节、小脑和脑干组,语言及定向认知域分值低于其他各组(P<0.05)。结论不同部位脑梗死患者认知障碍的发生率及认知损害的特点不同。
Objective To investigate the characteristics of cognitive impairment in patients with acute ischemic stroke in different parts. Methods A total of 230 acute cerebral infarction patients (1 ~ 14 days) were enrolled in this study. They included 31 cases of frontal lobe, 27 cases of temporal lobe, 26 cases of parietal lobe, 21 cases of occipital lobe, 47 cases of basal ganglia, 35 cases of thalamus, 23 cases of cerebellum, 20 cases of brain stem; Cognitive function was evaluated by Montreal Cognitive Assessment (MoCA). Results (1) The incidence of cognitive impairment varied with different lesion sites. MoCA scores in frontal lobe group, temporal lobe group and thalamus group were lower than those in other groups (P <0.05) Basal ganglia group, cerebellum group and brainstem group (P <0.05). (2) In the frontal lobe group, visual spatial and executive function, attention cognitive domain and MoCA total score were lower than other groups <0.05). The score of cognitive domain in temporal lobe group was lower than that in other groups in terms of naming and delayed recall. There was significant difference between MoCA total score and parietal lobe group, occipital lobe group, basal ganglia group, cerebellum group and brainstem group P <0.05). MoCA score in parietal lobe group and occipital lobe group was lower than that in basal ganglia, cerebellum and brainstem group (P <0.05). In thalamic group, visual acuity and executive function, cognitive domain and MoCA score were lower than The parietal lobe, occipital lobe, basal ganglia, cerebellum and brainstem group had lower verbal and directional cognitive domains scores than those in other groups (P <0.05). Conclusion The incidence of cognitive impairment and the characteristics of cognitive impairment in patients with different cerebral infarction are different.