大腦中動脈不同程度狹窄患者認知功能損害的特點
發(fā)布時間：2018-12-07 20:44
【摘要】：目的:旨在觀察單側(cè)大腦中動脈狹窄(MCA)程度對患者認知功能的影響,分析比較不同程度狹窄患者認知損害的特點,為大腦中動脈狹窄或閉塞患者認知障礙臨床早期診斷提供依據(jù)。方法:連續(xù)選取2015年12月-2016年8月之間以“頭暈、乏力等癥狀”受檢于某軍區(qū)總醫(yī)院神經(jīng)功能檢查室符合入選標準的單側(cè)MCA狹窄者98例及正常對照30例,狹窄組按照其狹窄程度分為:輕度狹窄組36例、中度狹窄組30例、重度狹窄或閉塞組32例,所有患者均進行基本信息采集及常規(guī)實驗室檢查,同時采用中文版蒙特利爾認知評估量表(MOCA)及事件相關(guān)電位P300評價各組患者認知功能情況,并比較分析各組認知障礙的特點。結(jié)果:(1)狹窄組一般臨床資料與對照組間比較差異無統(tǒng)計學意義(P0.05)。與對照組相比,狹窄組P300潛伏期延長,波幅降低,差異均有統(tǒng)計學意義(P0.05)。狹窄組的MoCA總分及各認知域得分均較對照組低。在Mo CA總分、視空間/執(zhí)行功能、注意、語言、抽象、延遲記憶得分方面,兩組比較差異均有統(tǒng)計學意義(P0.05)。狹窄組在命名、定向力得分雖較對照組低,但差異無統(tǒng)計學意義(P0.05)。(2)輕度狹窄組、中度狹窄組、重度狹窄或閉塞組、對照組四組間事件相關(guān)電位P300潛伏期、波幅比較,差異均有統(tǒng)計學意義(P0.05)。輕度狹窄組、中度狹窄組、重度狹窄或閉塞組較對照組P300潛伏期延長、波幅降低,差異均有統(tǒng)計學意義(P0.05);中度狹窄組較輕度狹窄組P300潛伏期延長,差異有統(tǒng)計學意義(P0.05),波幅結(jié)果近似,差異無統(tǒng)計學意義(P0.05)。重度狹窄或閉塞組較輕度狹窄組、中度狹窄組P300潛伏期延長、波幅降低,差異均有統(tǒng)計學意義(P0.05);(3)輕度狹窄組、中度狹窄組、重度狹窄或閉塞組、對照組四組間MoCA總分、視空間/執(zhí)行功能、注意、語言、抽象、延遲記憶得分比較,差異均有統(tǒng)計學意義(P0.05)。輕度狹窄組、中度狹窄組、重度狹窄或閉塞組MoCA總分及各認知域得分均較對照組低,但僅在MoCA總分、注意、語言、抽象、延遲回憶方面,差異有統(tǒng)計學意義(P0.05)。中度狹窄組延遲回憶得分較輕度狹窄組低,差異有統(tǒng)計學意義(P0.05),Mo CA總分及其它各認知域得分差異無統(tǒng)計學意義(P0.05)。重度狹窄或閉塞組MoCA總分及各認知域得分均較輕度狹窄組、中度狹窄組低,但僅在Mo CA總分、視空間/執(zhí)行功能、注意、抽象、延遲回憶方面,差異有統(tǒng)計學意義(P0.05)。結(jié)論:(1)單側(cè)MCA狹窄影響患者認知功能,在視空間/執(zhí)行功能、注意、語言、抽象、延遲記憶幾個認知域表現(xiàn)更為明顯。(2)不同程度的MCA狹窄損害涉及的認知域不同,且各認知域損害嚴重程度也不同。
[Abstract]:Objective: to observe the effect of unilateral middle cerebral artery stenosis (MCA) on cognitive function in patients with middle cerebral artery stenosis, and to analyze and compare the characteristics of cognitive impairment in patients with different degrees of stenosis. To provide evidence for early diagnosis of cognitive impairment in patients with middle cerebral artery stenosis or occlusion. Methods: from December 2015 to August 2016, 98 patients with unilateral MCA stenosis and 30 normal controls who were examined with "dizziness, fatigue and other symptoms" in the neurological functional examination room of a military region General Hospital were selected. According to the degree of stenosis, the stenosis group was divided into three groups: mild stenosis group (n = 36), moderate stenosis group (n = 30), severe stenosis group (n = 32) and severe stenosis group (n = 32). At the same time, the Chinese version of Montreal Cognitive Assessment scale (MOCA) and event-related potential (P300) were used to evaluate the cognitive function of patients in each group, and to compare and analyze the characteristics of cognitive impairment in each group. Results: (1) there was no significant difference in general clinical data between the stenosis group and the control group (P0.05). Compared with the control group, the latency of P300 was prolonged and the amplitude of P300 was decreased in the stenosis group (P0.05). The total score of MoCA and the scores of each cognitive domain in the stenosis group were lower than those in the control group. There were significant differences in the total score of Mo CA, visual space / executive function, attention, language, abstraction, and delayed memory score between the two groups (P0.05). Although the scores of naming and orientation in the stenosis group were lower than those in the control group, there was no significant difference (P0.05) between the mild stenosis group, the moderate stenosis group, the severe stenosis group and the control group. Compared with the amplitude, the differences were statistically significant (P0.05). The latency and amplitude of P300 in mild stenosis group, moderate stenosis group, severe stenosis or occlusion group were significantly longer than those in control group (P0.05). The latency of P300 in moderate stenosis group was longer than that in mild stenosis group, the difference was statistically significant (P0.05), the amplitude of wave was similar, the difference was not statistically significant (P0.05). Severe stenosis or occlusion group than mild stenosis group, moderate stenosis group P300 latency prolonged, wave amplitude decreased, the differences were statistically significant (P0.05); (3) the scores of MoCA, visual space / executive function, attention, language, abstraction and delayed memory in mild stenosis group, moderate stenosis group, severe stenosis or occlusion group and control group were significantly different (P0.05). The scores of MoCA and cognitive domain in mild stenosis, moderate stenosis, severe stenosis or occlusion group were lower than those in control group, but there were significant differences in MoCA total score, attention, language, abstraction and delayed recall (P0.05). The score of delayed recall in moderate stenosis group was lower than that in mild stenosis group, and the difference was statistically significant (P0.05 total score of), Mo CA and scores of other cognitive domains had no statistical significance (P0.05). The scores of MoCA and cognitive domain in severe stenosis or occlusion group were lower than those in mild stenosis group and moderate stenosis group, but there were significant differences only in Mo CA total score, visual space / executive function, attention, abstraction and delayed recall (P0.05). Conclusion: (1) unilateral MCA stenosis affects cognitive function, especially in visual space / executive function, attention, language, abstraction, and delayed memory. (2) different degree of MCA stenosis is involved in different cognitive domains. And the severity of cognitive domain damage is different.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3
本文編號：2367838
[Abstract]:Objective: to observe the effect of unilateral middle cerebral artery stenosis (MCA) on cognitive function in patients with middle cerebral artery stenosis, and to analyze and compare the characteristics of cognitive impairment in patients with different degrees of stenosis. To provide evidence for early diagnosis of cognitive impairment in patients with middle cerebral artery stenosis or occlusion. Methods: from December 2015 to August 2016, 98 patients with unilateral MCA stenosis and 30 normal controls who were examined with "dizziness, fatigue and other symptoms" in the neurological functional examination room of a military region General Hospital were selected. According to the degree of stenosis, the stenosis group was divided into three groups: mild stenosis group (n = 36), moderate stenosis group (n = 30), severe stenosis group (n = 32) and severe stenosis group (n = 32). At the same time, the Chinese version of Montreal Cognitive Assessment scale (MOCA) and event-related potential (P300) were used to evaluate the cognitive function of patients in each group, and to compare and analyze the characteristics of cognitive impairment in each group. Results: (1) there was no significant difference in general clinical data between the stenosis group and the control group (P0.05). Compared with the control group, the latency of P300 was prolonged and the amplitude of P300 was decreased in the stenosis group (P0.05). The total score of MoCA and the scores of each cognitive domain in the stenosis group were lower than those in the control group. There were significant differences in the total score of Mo CA, visual space / executive function, attention, language, abstraction, and delayed memory score between the two groups (P0.05). Although the scores of naming and orientation in the stenosis group were lower than those in the control group, there was no significant difference (P0.05) between the mild stenosis group, the moderate stenosis group, the severe stenosis group and the control group. Compared with the amplitude, the differences were statistically significant (P0.05). The latency and amplitude of P300 in mild stenosis group, moderate stenosis group, severe stenosis or occlusion group were significantly longer than those in control group (P0.05). The latency of P300 in moderate stenosis group was longer than that in mild stenosis group, the difference was statistically significant (P0.05), the amplitude of wave was similar, the difference was not statistically significant (P0.05). Severe stenosis or occlusion group than mild stenosis group, moderate stenosis group P300 latency prolonged, wave amplitude decreased, the differences were statistically significant (P0.05); (3) the scores of MoCA, visual space / executive function, attention, language, abstraction and delayed memory in mild stenosis group, moderate stenosis group, severe stenosis or occlusion group and control group were significantly different (P0.05). The scores of MoCA and cognitive domain in mild stenosis, moderate stenosis, severe stenosis or occlusion group were lower than those in control group, but there were significant differences in MoCA total score, attention, language, abstraction and delayed recall (P0.05). The score of delayed recall in moderate stenosis group was lower than that in mild stenosis group, and the difference was statistically significant (P0.05 total score of), Mo CA and scores of other cognitive domains had no statistical significance (P0.05). The scores of MoCA and cognitive domain in severe stenosis or occlusion group were lower than those in mild stenosis group and moderate stenosis group, but there were significant differences only in Mo CA total score, visual space / executive function, attention, abstraction and delayed recall (P0.05). Conclusion: (1) unilateral MCA stenosis affects cognitive function, especially in visual space / executive function, attention, language, abstraction, and delayed memory. (2) different degree of MCA stenosis is involved in different cognitive domains. And the severity of cognitive domain damage is different.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3
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