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目的:分析无症状性脑梗死(SCI)患者认知功能障碍的因素。方法:96例SCI患者应用简易精神状态检查量表(MMSE)及中文版蒙特利尔认知评估量表(MoCA)的检测,并比较两种量表对无痴呆的血管性认知损害的检出率。依据检测结果分无痴呆的血管性认知损害(VCIND)组及认知功能正常(NCI)组,所有患者均进行一般状况评定和试验时间差,影像学检测病灶的部位和侧别,颈动脉彩色多普勒超声测定颈动脉粥样硬化程度。结果:MoCA量表测查VCIND的敏感性较MMSE明显增高,VCIND组病灶多位于大脑皮质,放射冠,丘脑,而NCI组病灶多位于基底节,脑干。颈动脉管腔内径,内膜中层厚度及不稳定斑块两组比较有差异,颈动脉稳定斑块两组比较无差异。结论:在SCI合并VCIND的检测中,MoCA量表的敏感性高于MMSE,MoCA对筛选SCI患者是否合并VCIND有临床指导意义。SCI中VCIND的发生与病灶部位及侧别,颈动脉管腔内径,IMT,斑块的稳定性有关。
Objective: To analyze the factors of cognitive dysfunction in patients with asymptomatic cerebral infarction (SCI). Methods: 96 cases of SCI patients with mental state examination (MMSE) and the Chinese version of the Montreal Cognitive Assessment Scale (MoCA) detection, and comparison of two scales for dementia vascular cognitive impairment rate . According to the test results, we divided the VCIND group and the NCI group. All patients were assessed for the general status and the time difference between the two groups. The location and side of the lesion, the color of carotid artery Doppler ultrasound measurement of carotid atherosclerosis. Results: The sensitivity of the MoCA scale to detect VCIND was significantly higher than that of MMSE. Most of the lesions in the VCIND group were located in the cerebral cortex, corona, and thalamus, whereas those in the NCI group were mostly in the basal ganglia and brainstem. Carotid artery lumen diameter, intima-media thickness and unstable plaque were different between the two groups, carotid artery plaque stability was no difference between the two groups. Conclusion: The sensitivity of the MoCA scale is higher than that of the MMSE in the detection of VCIND in SCI. MoCA is clinically instructive in screening patients with SCI for VCIND. The occurrence of VCIND in SCI is related to the location of lesion and side, the lumen diameter of carotid artery, the IMT and the stability of plaque.