摘要
Abstract
Objective To analyze the related risk factors in terms of cognitive dysfunction for the patients with cerebral infarction associated with cerebral small vessel disease .Methods One hundred and five patients in Neurology Department of Nantong First Peoples′Hospital with acute cerebral infarction from August 2012 to January 2014 were selected .According to MRI , 41 patients were associated with cerebral small vessel disease ( CSVD ) , and the other 64 patients were not associated with CSVD .The demographic indicators,such as the patient′s age,gender,education level,existing risk factors and clinical features were evaluated,looking for risk factors for CSVD.By using Montreal cognitive assessment (MoCA),49 patients were screened out with vascular cognitive impairment (VCI)from all the selected patients,the remaining 56 patients without cognitive dysfunction .The demographic characteristics of the two groups were compared to analyzerelated risk factors of cognitive dysfunction .The correlation between CSVD and cognitive dysfunction were studied by using the logistic regression and Spearman rank correlation analysis .Resulst Compared the group with CSVD and the group without CSVD ,the proportion of hypertension was34 cases (82.9%) and 29 cases(45.3%,χ2=14.732 ,P=0.000),the proportion of high cholesterol was 36 cases(87.8%) and 25 cases (39.1%,χ2 =24.834,P=0.000),the proportion of coronary heart disease was 37cases(90.2%)and 28 cases(43.8%,χ2=24.920,P=0.000);The age of CSVD group [(73.13 ±4.96)years] is greater than that of group without CSVD [ ( 68.45 ±7.05 ) years ,t=4.374,P=0.015 ];MoCA scores of groups with and without CSVD were ( 23.50 ±2.102 ) scores and( 27.46 ±1.823 ) scores;The attention function score [(3.09 ±0.916 )scores]and the visual spatial and executive ability score [(3.46 ±0.163)scores ]of the group with CSVD were less than the group without CSVD (t=5.384 ,11.546 ,all P<0.05 ) .The proportion of diabetes was20 cases ( 48.7%) and 34 cases ( 53.1%,χ2 =0.003 , P =0.960 ) .The age of cognitive dysfunction group [ ( 70.86 ±6.43 ) years ] was greater than the group without cognitive dysfunction [(65.03 ±5.29)years,t =7.651,P=0.010];The average years of education of group without cognitive dysfunction group [(4.32 ±1.326)years] were less than the cognitive dysfunction group [(6.19 ±2.478) years,t=7.850,P=0.000];The proportion of involvement of subcortical key parts of cognitive dysfunction group and the group without cognitive dysfunction was 33 cases(71.7%)and 26 cases(46.4%,χ2 =4.645, P=0.048 ) .The difference between the infarct volume of cognitive dysfunction group [ ( 6.461 ±1.385 ) mm3]and that of group without cognitive dysfunction [(6.280 ±1.472)mm3,t=0.635,P=0.587 ]had no statistical significance.Conclusions Hypertension ,high cholesterol ,coronary heart disease,and age are risk factors of CSVD .The cerebral infarction patients associated with CSVD are more likely to show cognitive dysfunction .The parts involved by CSVD are closely related to the extent of cognitive dysfunction .The attention and executive dysfunctionin is the main feature of vascular cognitive impairment associated with CSVD.关键词
脑小血管病/脑梗死/认知障碍Key words
Cerebral small vessel disease/Cerebral infarction/Cognitive impairment
