不同脑小血管病负荷评分与伴无症状腔隙的脑小血管病患者认知功能的关系OACSTPCD
Relationship between cerebral small vessel disease burden scores and cognitive function in patients with cerebral small vessel disease with asymptomatic lacunes
目的 探讨不同脑小血管病(CSVD)负荷评分与伴无症状腔隙的CSVD患者认知功能的关系.方法 纳入2021年7月—2023年10月就诊于潍坊市人民医院神经内科的128例伴无症状腔隙的CSVD患者,运用蒙特利尔量表(MoCA)、CSVD总负荷评分和改良负荷评分统计受试者的认知功能和CSVD负荷,分为认知障碍组(MoCA<26分)和无认知障碍组(MoCA≥26分),比较两组患者的人口社会学信息、血管病危险因素及CSVD负荷评分的差异.采用线性回归分析MoCA评分与两种CSVD负荷评分的关系,采用趋势检验分析伴无症状腔隙的CSVD患者认知障碍的发病趋势.结果 研究共纳入伴无症状性腔隙的CSVD患者128例,其中认知障碍组68例(53.1%),无认知障碍组60例(46.9%),两组患者人口社会学信息及血管病危险因素差异无统计学意义(P>0.05).两组患者的CSVD总负荷评分和改良负荷评分比较均存在统计学差异(P<0.05).Spearman秩相关分析显示,CSVD总负荷评分和改良负荷评分均与MoCA评分呈负相关(P<0.001).线性趋势χ2检验分析显示,伴无症状腔隙的CSVD患者认知障碍发病风险随CSVD改良负荷评分增加而增加(Ptrend<0.05),该发病风险与CSVD总负荷评分间趋势分析无统计学意义(Ptrend=0.069).结论 CSVD总负荷评分和改良负荷评分均可用于筛检伴无症状腔隙的CSVD认知障碍患者.改良负荷评分可能在识别认知障碍高风险患者方面更具优势.
Objective To investigate the relationship between cerebral small vessel disease(CSVD)burden scores and cognitive function in patients with CSVD with asymptomatic lacunes.Methods A total of 128 patients with CSVD with asymptomatic lacunes who visited the Department of Neurology of Weifang People′s Hospital from July 2021 to October 2023 were included.All the patients were scored using the Montreal Cognitive Assessment(MoCA)for cognitive function and using the total CSVD score and the modified CSVD score for CSVD burden.They were divided into cognitive impairment group(MoCA score<26)and non-cognitive impairment group(MoCA score≥26).The demographic information,vascular disease risk factors,and the CSVD scores of the two groups were compared.A linear regression analysis was performed to as-sess the relationship between the MoCA score and the two CSVD scores.A trend analysis was conducted to analyze the trend of incidence of cognitive impairment in patients with CSVD with asymptomatic lacunes.Results Among the 128 patients with CSVD with asymptomatic lacunes,68(53.1%)were in the cognitive impairment group and 60(46.9%)were in the non-cognitive impairment group.There were no significant differences in the demographic information and vascular disease risk factors between the two groups(P>0.05).The total CSVD score and the modified CSVD score differed significantly be-tween the two groups(P<0.05).The Spearman correlation analysis showed that the total and modified CSVD scores were sig-nificantly negatively correlated with the MoCA score(P<0.001).The chi-square test for linear trend revealed that the cogni-tive impairment risk increased significantly with the modified CSVD score in patients with CSVD with asymptomatic lacunes(Ptrend<0.05),but with no significance for the total CSVD score(Ptrend=0.069).Conclusion Both the total and modified CSVD scores are useful tools to detect cognitive impairment in patients with CSVD with asymptomatic lacunes,and the modi-fied CSVD score may be superior in identifying patients at high risk of cognitive impairment.
杜晓光;魏荣;刘琦慧;于力群;周丽
潍坊市人民医院神经内科,山东 潍坊 261000
临床医学
脑小血管病认知腔隙
Cerebral small vessel diseaseCognitionLacune
《中风与神经疾病杂志》 2024 (004)
325-328 / 4
潍坊市科学技术局科学技术发展计划项目(2021YX061)
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