缺血性卒中患者脑白质病变对认知功能的影响

目的 探讨不同程度的脑白质病变对缺血性卒中患者认知功能的影响。方法 连续收集缺血性卒中患者，记录卒中危险因素，进行蒙特利尔认知评估量表（Montrealcognitive assessment，MoCA）等神经心理学测试，进行神经影像学检查，运用与年龄相关的脑白质改变分级量表（age-related white matter changes rating scale，ARWMCRs）对脑白质病变半定量评分。根据ARWMCRs评分结果，将患者分为3组：轻度组、中度组和重度组。比较轻、中、重三组间认知功能的差异。结果 与脑白质病变轻度组比较，中、重度组患者MoCA评分下降（P均＜0.01)。相关性分析发现ARWMCRs评分与MoCA评分呈负相关（r =-0.677，P＜0.01）。结论 脑白质病变影响缺血性卒中患者的认知功能。脑白质病变程度越重，认知功能下降就越为显著。

A Study of White Matter Lesions on Cognitive Function in Patients with Ischemic Cerebrovascular Disease

Objective To investigate different degrees of white matter lesions on cognitive function in patients with ischemic cerebrovascular disease. Methods Patients with ischemic cerebrovascular disease were consecutively included. Stroke risk factors were recorded. Nenropsychological tests, such as the Montreal cognitive assessment（MoCA）, were carried out. Age-related white matter changes rating scale（ARWMCRs） was used to semi- quantitative score white matter lesions following neuroimaging examination. According to the ARWMCRs scores, patients were divided into three groups： mild, moderate and severe group. The difference of neuropsychology, neural electrophysiology and the ability of daily life were compared among the three groups. Results The moderate and severe groups got lower neuropsychological testing scores（P〈0.01） compared with the mild group. Correlation analysis showed that white matter lesions had a negative relationship with neuropsychological tests（MoCA）（r=-0.677, P〈0.01）, Conclusion White matter lesions impact patients with ischemic cerebrovascular disease in cognitive function, the more serious of white matter lesions, the more significant decline in cognitive function.