本文選題：認知功能 + 卒中��； 參考：《浙江大學》2012年碩士論文

【摘要】：背景： 卒中后認知損害為當前研究熱點,不同部位卒中引起的認知改變模式仍在不斷探索和爭議中。腦卒中后除了有軀體功能缺損,往往還伴有認知功能改變。以往認為皮層為主要大腦功能結構區(qū),但是近年來發(fā)現(xiàn)皮層下結構也參與腦高級功能的形成。國內外對丘腦及基底節(jié)區(qū)卒中后各認知領域改變的研究仍較少。本課題擬從不同病灶部位認知損害比較的角度研究皮層下關鍵部位丘腦及基底節(jié)區(qū)卒中的神經心理特點,為早期識別血管性認知損害(VCI)患者提供依據,也為卒中后康復措施的制定提供依據。 目的： 本課題使用成套神經心理量表研究丘腦及基底節(jié)區(qū)卒中患者的認知改變特點,以推測皮層下結構與大腦高級功能的關系。本課題的意義在于認識非皮層結構損害后腦高級功能的改變模式,推測大腦深部結構的高級功能分化,從而在臨床上為建構合理的VCI認知評估提供實證依據,同時,也便于早期識別VCI患者,并進行有效干預從而降低血管性癡呆(VaD)發(fā)病,減輕社會負擔。 方法： 2009年12月至2011年11月之間,連續(xù)收集浙江省嵊州市人民醫(yī)院神經內科門診和住院的丘腦或基底節(jié)區(qū)單病灶卒中病人88例為病例組做橫斷面研究(左側卒中41例,右側卒中47例),其中男性64例,女性24例。分為以下四組：左側丘腦卒中組(n=20)、右側丘腦卒中組(n=21)、左側基底節(jié)區(qū)卒中組(n=21)、右側基底節(jié)區(qū)卒中組(n=26)；并入選健康老人34名為正常對照組,其中男性27名,女性7名。以上研究對象年齡均在50～80歲,教育年限、性別、年齡和抑郁自評量表差異無統(tǒng)計學意義。全部對象均完成成套認知功能檢查,包括總體認知水平、記憶、語言、執(zhí)行、注意和空間功能等各個認知領域。用SPSS11.5統(tǒng)計軟件對各組認知指標進行分析。 結果： ①病例組與對照組比較：病例組在記憶功能、注意/執(zhí)行功能、語言功能、空間功能等存在廣泛的認知損害,明顯差于對照組。②4組病例在相似性測驗分析均有明顯下降,其中左側丘腦卒中組患者表現(xiàn)最差,左側丘腦卒中組和右側丘腦卒中組患者明顯差于左側基底節(jié)區(qū)卒中組和右側基底節(jié)區(qū)卒中組患者,說明相似性測驗得分與左右丘腦關系密切。③左側丘腦卒中組和其他卒中組相比較：在言語功能、抑制干擾能力、信息處理速度和準確性、聽覺詞語延遲回憶、注意/執(zhí)行功能、空間功能具有顯著差異,與其他3個卒中組患者相比,左側丘腦卒中組患者對認知功能影響最嚴重。④左側基底節(jié)區(qū)卒中組和其他組比較：左側基底節(jié)區(qū)卒中組患者的特點是與右手操作相關的項目(如TMT、SDMT)表現(xiàn)優(yōu)于其他3個卒中組患者,而接近正常對照組。⑤右側基底節(jié)區(qū)卒中組和其他組比較：SCWT-C正確數右側基底節(jié)區(qū)卒中組患者表現(xiàn)最好,顯著優(yōu)于左側丘腦、左側基底節(jié)區(qū)卒中組患者,但與正常對照組比較,仍有明顯下降。 結論： ①丘腦、基底節(jié)區(qū)卒中患者的認知損害較全面,包括記憶功能、執(zhí)行功能、注意功能、語言功能和空間功能都受到顯著影響,但損害模式各有不同,損害部位不同,認知損害表現(xiàn)不同。②左側丘腦卒中患者的認知損害相對最為嚴重。
[Abstract]:Background :

The cognitive impairment after stroke is the focus of the current research , and the cognitive change pattern caused by stroke in different parts is still being explored and disputed . In addition to the body function defect after stroke , the cognitive function change is often accompanied by the change of cognitive function . In recent years , it has been found that the subcortical structure is also involved in the formation of brain advanced function .

Purpose :

This topic uses a set of neuropsychological scales to study the cognitive changes of stroke patients in the thalamus and basal ganglia , so as to predict the relationship between the subcortical structure and the advanced function of the brain . The purpose of this project is to recognize the change pattern of the advanced function of the brain in the non - cortical structure , and to estimate the high - level functional differentiation of the deep brain structure . At the same time , it is convenient for early identification of VCI patients and effective intervention to reduce the incidence of vascular dementia ( VaD ) and reduce the social burden .

Method :

From December 2009 to November 2011 , 88 cases of single - focus stroke patients in Shengzhou People ' s Hospital of Zhejiang Province were collected continuously , including 64 males and 24 females , including 64 males and 24 females , including 64 males and 24 females , including the following four groups : left anterior cerebral stroke group ( n = 20 ) , right group stroke group ( n = 21 ) , left basal ganglia stroke group ( n = 21 ) , right basal ganglia stroke group ( n = 26 ) ;
All the subjects completed a complete set of cognitive functions , including overall cognitive level , memory , language , execution , attention and spatial functions .

Results :

Compared with the control group , there were significant differences in cognitive function between the right basal ganglia stroke group and the right basal ganglia stroke group .

Conclusion :

The cognitive impairment of stroke patients in thalamus and basal ganglia was more comprehensive , including memory function , executive function , attention function , language function and spatial function were significantly affected , but the damage pattern was different , the lesion site was different , and the cognitive impairment was different . 鈶，

本文編號：1953555