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目的:探讨前、后循环颅内动脉重度狭窄或闭塞患者认知功能的特点。方法:选择Alberta卒中项目早期CT评分(Alberta stroke program early CT score,ASPECTS)和后循环ASPECTS(posterior circulation ASPECTS,pc-ASPECTS)评分均为10分的患者,应用蒙特利尔认知评价量表(MMSE)、简易精神状态评价量表(MoCA)和多维心理评估系统对30例前循环颅内动脉重度狭窄或闭塞患者(前循环组)和23例后循环颅内动脉重度狭窄或闭塞患者(后循环组)和53例无卒中或短暂脑缺血发作的对照组患者进行神经心理评估。结果:前、后循环颅内动脉重度狭窄或闭塞患者时间定向力[对照组:5.00(5.00,10.00)分,前循环组:5.00(5.00,5.00)分,后循环组:5.00(5.00,5.00)分]、注意力[对照组:6.00(5.00,6.00)分,前循环组:5.00(4.00,6.00)分,后循环组:5.00(4.00,6.00)分]、词语辨析测验[对照组:70.00(60.00,82.00)分,前循环组:48.00(20.50,67.50)分,后循环组:53.50(33.25,75.25)分]等评分显著低于对照组(均n P<0.05);前循环颅内动脉重度狭窄或闭塞患者记忆[对照组:3.00(2.00,3.00)分,前循环组:2.00(1.00,3.00)分]、MMSE[对照组:29.00(28.00,30.00)分,前循环组:28.00(26.75,29.00)分]、简单数字计算[对照组:72.00(53.50,85.50)分,前循环组:53.50(37.00,73.00)分]等评分显著低于对照组(均n P<0.05);后循环颅内动脉重度狭窄或闭塞患者视空间执行功能[对照组:4.00(3.00,5.00)分,后循环组:3.00(2.00,4.00)分]、数字序列推理[对照组:74.50(51.50,83.00)分,后循环组:42.00(28.00,70.00)分]等评分显著低于对照组(均n P<0.05);后循环颅内动脉重度狭窄或闭塞患者空间工作记忆测验评分[对照组:77.50(51.75,89.00)分,前循环组:56.50(34.00,72.50)分,后循环组:31.00(18.50,58.00)分]显著低于其他两组(均n P<0.05)。n 结论:前、后循环颅内动脉重度狭窄或闭塞导致不同种类的认知功能损害。本研究可为临床对颅内动脉重度狭窄或闭塞患者认知功能损害早期采取有效的针对性治疗和康复措施提供客观依据。“,”Objective:To investigate the impact of severe stenosis or occlusion of intracranial artery in anterior and posterior circulation on cognitive function in patients.Methods:Patients with Alberta stroke program early CT score(ASPECTS) and posterior circulation ASPECTS(pc-ASPECTS) of 10 were selected, and neuropsychological assessments were performed in 30 patients with intracranial artery severe stenosis or occlusion in anterior posterior circulation (anterior circulation group)and 23 patients with intracranial artery severe stenosis or occlusion in posterior circulation(posterior circulation group) and 53 control subjects using MMSE, MoCA and multidimensional psychological assessment system.Results:The scores of time orientation(control group: 5.00(5.00, 10.00), anterior circulation group: 5.00(5.00, 5.00), posterior circulation group: 5.00(5.00, 5.00)), attention (control group: 6.00(5.00, 6.00), anterior circulation group: 5.00(4.00, 6.00), posterior circulation group: 5.00(4.00, 6.00)) and word discrimination test (control group: 70.00(60.00, 82.00), anterior circulation group: 48.00(20.50, 67.50), posterior circulation group: 53.50(33.25, 75.25)) were significantly lower in patients of anterior circulation group and posterior circulation group than those of control group(all n P<0.05); The scores of memory(control group: 3.00(2.00, 3.00), anterior circulation group: 2.00(1.00, 3.00), MMSE(control group: 29.00(28.00, 30.00), anterior circulation group: 28.00(26.75, 29.00)) and simple subtraction(control group: 72.00(53.50, 85.50), anterior circulation group: 53.50(37.00, 73.00)) were significantly lower in patients of anterior circulation group than those of control group(alln P<0.05); The scores of visuospatial executive function(control group: 4.00(3.00, 5.00), posterior circulation group: 3.00(2.00, 4.00)) and digital sequence reasoning(control group: 74.50(51.50, 83.00), posterior circulation group: 42.00(28.00, 70.00)) were significantly lower in patients of posterior circulation group than those of control group(alln P<0.05); The scores of spatial working memory test(control group: 77.50(51.75, 89.00), anterior circulation group: 56.50(34.00, 72.50), posterior circulation group: 31.00(18.50, 58.00))were significantly lower in patients of posterior circulation group than those of the other two groups(alln P<0.05).n Conclusion:Severe stenosis or occlusion of intracranial arteries in anterior and posterior circulation is associated with cognitive impairment in patients.Vascular lesions in different parts can lead to cognitive impairment in different aspects.