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目的:探讨脑血管病患者认知功能改变与脑室线性结构的相关性,进一步探讨血管性认知障碍的临床特点。方法:采用CT/MRI技术测量脑梗死、腔隙性脑梗死、脑出血的病灶体积和脑室线性结构;应用简易精神状态智能量表,中国成人智力量表中的词义分辨项、数字背诵项;临床记忆量表中的图像自由回忆、无意义图形再认、人像特点联系回忆项,连线测验A、连线测验B组成的神经心理量表进行认知功能测定。结果:脑梗死组、腔隙性脑梗死组、脑出血组、健康对照组4组之间大多数认知功能无差异,仅在认知功能的回忆力分项中脑出血组与健康对照组之间有差异,脑出血组回忆力成绩低于健康对照组(P<0.05)。患者哈氏值、脑室指数、前角指数、三脑室宽度与正常值比较差异均有统计学意义(P<0.05)。哈氏值和三脑室宽度较正常值增大。脑室指数和前角指数较正常值减小。脑室指数与回忆力呈正相关(r=0.280,P<0.05)。前角指数与MMSE总分、定向力、回忆力呈正相关(r=0.322、0.337、0.368,P<0.05),与连线测验A和连线测验B所用时间呈负相关(r=0.278、-0.334,P<0.05)。结论:脑血管病可引起认知功能下降。脑血管病患者存在不同程度的脑萎缩,尤以额叶皮质和皮质下深部白质的萎缩明显。
Objective: To explore the correlation between the changes of cognitive function and the linear structure of ventricles in patients with cerebrovascular disease and to further explore the clinical features of vascular cognitive impairment. Methods: CT volume was calculated by CT / MRI technique. The volumes of cerebral infarction, lacunar infarction and intracerebral hemorrhage and the linear structures of cerebral ventricle were measured. The mental state intelligence scale, Chinese word recognition, Clinical memory scale in the image of free recall, meaningless graphics recognition, contact characteristics of the facial features, connection test A, connection test B composed of neuropsychological measures for cognitive function. Results: There was no difference in most cognitive functions between the cerebral infarction group, the lacunar infarction group, the cerebral hemorrhage group and the healthy control group. Only in the cerebral infarction group, cerebral hemorrhage group and healthy control group There was a difference between the two groups. The scores of memory in cerebral hemorrhage group were lower than those in healthy control group (P <0.05). Hash value, ventricular index, anterior horn index, width of the third ventricle and normal were significantly different (P <0.05). Haste’s value and the width of the third ventricle increased more than normal. Ventricular index and anterior angle index decreased compared with normal. Ventricular index and memory were positively correlated (r = 0.280, P <0.05). The anterior horn index was positively correlated with MMSE score, directional force and memory (r = 0.322,0.337,0.368, P <0.05), and was negatively correlated with the time spent on test A and test B (r = 0.278, - 0.334, P <0.05). Conclusion: Cerebrovascular disease can cause cognitive decline. Cerebral vascular disease patients have varying degrees of brain atrophy, especially in the frontal cortex and subcortical deep white matter atrophy.