Abstract
Objective To investigate the characteristics and risk factors of cognitive dysfunction due to different types of cerebral small vascular disease(CSVD). Methods One hundred and eighteen patients who hospitalized in the Department of Neurology,the First Hospital of Hebei Medical University from 2012 to 2013,were selected. They were divided into 3 groups according to the manifestations of MRI:white matter lesion( WML)group(40 cases),lacunar infarction( LI)group(38 cases),WML + LI group(40 cases). Meanwhile,39 people who had normal MRI findings from the outpatient were selected as control group. We recorded and measured the patient′s gender,age,education years,as well as the medical history(smoking, drinking,hypertension,diabetes,hyperlipidemia,stroke)and the hs-CRP level,respectively. All cases were scored by Mini- Mental State Examination( MMSE),Montreal Cognitive Assessment( MoCA),and Clinical Dementia Rating( CDR). Furthermore,the risk factors for cognitive dysfunction in CSVD patients were evaluated by multivariate Logistic regression analysis. Results There were significantly statistical differences in the total score of MMSE and scores in the domains of memory,recall,attention and calculation among the four groups(P < 0. 05). Compared with the control group,WML group had lower total score of MMSE and scores in domains of memory and recall(P < 0. 05),LI group had lower total score of MMSE and scores in domain of recall( P < 0. 05). WML + LI group had lower total score of MMSE and scores in the domains of memory,recall,attention and calculation than other groups(P < 0. 05). In addition,the differences in total score of MoCA and scores in domains of visual space and executive function,memory,language and calculation among the four groups were statistically significant(P < 0. 05). Compared with the control group,the total score of MoCA,scores in the domains of visual space and executive function,memory,language were lower in the WML group(P < 0. 05),the total score of MoCA,scores in the domains of visual space and executive function,language were lower in the LI group( P < 0. 05). WML + LI group had lower total score of MoCA,lower scores in the domains of visual space and executive function,language and calculation compared with other groups(P < 0. 05),however,only the score in the memory were lower than LI group and control group(P< 0. 05). The degree of dementia was more severe in WML and LI groups than that in the control group(P < 0. 05);however, it was the most severe in the WML + LI group(P < 0. 05). Results of multivariate Logistic regression analysis showed that longer years of education was a protect factor〔OR = 0. 684,95% CI(0. 561,0. 835)〕,while advanced age〔OR = 1. 092,95% CI (1. 022,1. 168 )〕,smoking〔 OR = 3. 732,95% CI( 1. 058,13. 164 )〕,drinking〔 OR = 4. 615,95% CI ( 1. 094, 19. 465)〕,diabetes〔OR = 2. 937,95% CI(1. 016,8. 491)〕,hyperlipidemia〔OR = 3. 207,95% CI(1. 024,10. 045)〕and high level of hs-CRP〔OR = 1. 245,95% CI(1. 040,1. 492)〕were risk factors for cognitive dysfunction in CSVD patients (P < 0. 05). Conclusion The characteristics of cognitive dysfunction are different in various types of CSVD,the differences mainly showed in domains of visual space and executive function,memory,language and calculation cognitive,furthermore, WML combined with LI will aggravate cognitive impairment and dementia. Advanced age, smoking, drinking, diabetes, hyperlipidemia and high level of hs-CRP are risk factors of cognitive dysfunction in CSVD patients.关键词
脑小血管疾病/中风,腔隙性/脑白质病/认知障碍/危险因素Key words
Cerebral small vessel diseases/Stroke, lacunar/Leukoencephalopathies/Cognition disorders/Risk factors分类
医药卫生
