脑白质疏松对遗忘型轻度认知障碍患者认知功能和日常生活能力的影响
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摘要
目的探究脑白质疏松对遗忘型轻度认知障碍患者认知功能和日常生活能力的影响。方法前瞻性选择2017年2月至2018年1月唐山市开滦总医院收治的41例遗忘型轻度认知障碍患者,设为观察组;选择同期入院健康志愿者40例,设为对照组。对两组的资料进行分析,使用MMSE、Mattis痴呆评定量表(MDRS)、日常生活能力评估量表(ADL)对两组的认知功能、日常生活能力进行评估;同时通过Fazekas方法中的脑室旁白质高信号(PVH)、深部白质高信号(DWMH)对其脑白质病变程度进行评分;以ADL作为因变量,以年龄、受教育年限、PVH评分、DWMH评分、MMSE评分作为自变量进行多元逐步回归分析。结果观察组MMSE、MDRS的评分均显著低于对照组,差异具有统计学意义(P <0. 05)。观察组ADL、PVH、DWMH的各项评分均高于对照组,差异存在统计学意义(P <0. 01)。多元逐步回归Logistic分析结果表明:观察组患者ADL评分与年龄无显著相关(P> 0. 05);与受教育年限、PVH评分、DWMH评分、MMSE评分、MDRS评分显著相关(P <0. 05)。结论遗忘型轻度认知障碍患者脑白质疏松情况越严重,对其认知功能、日常生活能力的影响就越大。
Objective To investigate the effects of leukoaraiosis on cognitive function and daily living ability in patients with amnestic mild cognitive impairment. Methods From February 2017 to January 2018,41 patients with amnestic mild cognitive impairment were selected into the observation group. 40 healthy volunteers were selected into the control group. The data of the two groups were analyzed,and the cognitive function and daily living ability of the two groups were evaluated by MMSE,Mat-tis Dementia Rating Scale( MDRS) and Daily Living Ability Assessment Scale( ADL). At the same time,the Fazekas method was used. The ventricle high white signal( PVH) and deep white matter high signal( DWMH) scored the degree of white matter lesions; ADL was used as the dependent variable,age,education years,PVH score,DWMH score,MMSE score Multivariate stepwise regression analysis was performed as an independent variable. Results The scores of MMSE and MDRS in the observation group were significantly lower than those in the control group,and the difference was statistically significant( P < 0. 05). The scores of ADL,PVH and DWMH in the observation group were higher than those in the control group,and the difference was statistically significant( P < 0. 01). Multivariate stepwise regression logistic analysis results showed that there was no significant correlation between ADL score and age in the observation group( P > 0. 05). The ADL score of the observation group was significantly correlated with the years of education,PVH score,DWMH score,MMSE score and MDRS score( P < 0. 05). Conclusion The more severe the leukoaraiosis in patients,the greater the impact on their cognitive function and daily living ability.
Objective To investigate the effects of leukoaraiosis on cognitive function and daily living ability in patients with amnestic mild cognitive impairment. Methods From February 2017 to January 2018,41 patients with amnestic mild cognitive impairment were selected into the observation group. 40 healthy volunteers were selected into the control group. The data of the two groups were analyzed,and the cognitive function and daily living ability of the two groups were evaluated by MMSE,Mat-tis Dementia Rating Scale( MDRS) and Daily Living Ability Assessment Scale( ADL). At the same time,the Fazekas method was used. The ventricle high white signal( PVH) and deep white matter high signal( DWMH) scored the degree of white matter lesions; ADL was used as the dependent variable,age,education years,PVH score,DWMH score,MMSE score Multivariate stepwise regression analysis was performed as an independent variable. Results The scores of MMSE and MDRS in the observation group were significantly lower than those in the control group,and the difference was statistically significant( P < 0. 05). The scores of ADL,PVH and DWMH in the observation group were higher than those in the control group,and the difference was statistically significant( P < 0. 01). Multivariate stepwise regression logistic analysis results showed that there was no significant correlation between ADL score and age in the observation group( P > 0. 05). The ADL score of the observation group was significantly correlated with the years of education,PVH score,DWMH score,MMSE score and MDRS score( P < 0. 05). Conclusion The more severe the leukoaraiosis in patients,the greater the impact on their cognitive function and daily living ability.
引文
[1]陈燕梅,李毅,李海林,等.脑白质疏松对遗忘型轻度认知障碍患者认知功能和日常生活能力的影响[J].临床神经病学杂志,2017,30(5):330-332.
[2]胡荣亮,陈卓铭,冯尚武,等.经颅直流电刺激小脑对遗忘型轻度认知功能障碍患者言语工作记忆能力的影响[J].中华物理医学与康复杂志,2016,38(4):267-271.
[3]张禹,冯园,郭大志,等.脑白质疏松症的基因与蛋白组学研究进展[J].中国医药导报,2017,14(22):55-58.
[4]温优良,罗毅卿,唐小冬,等.经皮穴位电刺激治疗脑卒中后认知功能障碍的临床随机对照研究[J].中国全科医学,2017,20(z2):12-15.
[5]丁蓓,张泳,黄娟,等.遗忘型轻度认知障碍患者脑血流灌注与认知功能的回归分析[J].放射学实践,2016,31(7):595-598.
[6]董娜,张贵丽,张宏伟.轻度认知障碍的神经心理表现及解剖结构损害的分型研究[J].中风与神经疾病杂志,2016,33(1):49-53.
[7]中华医学会神经病学分会痴呆与认知障碍学组写作组,中国阿尔茨海默病协会(ADC).中国痴呆与认知障碍诊治指南:轻度认知障碍的诊断和治疗[J].中华医学杂志,2010,90(41):2887-2893.
[8]童宣霞,王龙,周霞,等.脑萎缩对皮质下缺血性血管病患者认知功能的影响[J].中华医学杂志,2016,96(1):14-19.
[9]张宏强.针刺联合高压氧治疗脑白质疏松症伴轻度认知障碍临床观察[J].检验医学与临床,2017,14(A02):156-157.
[10]杨照玲,葛平.养血清脑颗粒治疗脑白质疏松伴轻度认知障碍患者的临床观察[J].山西医药杂志,2016,45(3):299-301.
[11]杨娟,赵晓晖,白青科,等.血清组胺与脑白质疏松症认知功能障碍的相关性[J].脑与神经疾病杂志,2016,24(6):335-338.
[12]李越秀,王金芳,沈慧聪,等.脑白质疏松症伴轻度认知损害患者静息态功能磁共振成像研究[J].中国现代神经疾病杂志,2016,16(5):264-270.
[13]郑纪平,赵伟丽,李国丽.老年急性脑梗死合并脑白质疏松症患者的认知功能障碍研究[J].临床和实验医学杂志,2014,13(2):106-109.
[14]陈红霞,郭姗姗,武一平,等.非痴呆性血管性认知障碍的研究进展[J].中国卒中杂志,2017,12(12):1148-1153.
[15]周爱红.血管性认知功能障碍防治[J].中国实用内科杂志,2016,36(11):942-946.
[16]王金芳,陈红艳,李越秀,等.脑白质疏松患者大脑功能网络小世界属性的静息态功能磁共振研究[J].中华行为医学与脑科学杂志,2017,26(11):977-982.
[17]李海涛,李桂花,哈斯也提·依不来音,等.载脂蛋白Eε4基因对轻度认知功能障碍患者脑白质微细结构损害研究[J].中国全科医学,2016,19(26):3175-3179.
[18]丁蓓,凌华威,陈克敏.轻度认知功能障碍的神经影像学研究进展[J].国外医学(临床放射学分册),2007,30(2):77-80.
[19]肖世富,陈兴时,薛海波,等.老年轻度认知功能损害的脑诱发电位变化及其发展为痴呆的预测因素[J].老年医学与保健,2005,11(4):219-222,229.
[2]胡荣亮,陈卓铭,冯尚武,等.经颅直流电刺激小脑对遗忘型轻度认知功能障碍患者言语工作记忆能力的影响[J].中华物理医学与康复杂志,2016,38(4):267-271.
[3]张禹,冯园,郭大志,等.脑白质疏松症的基因与蛋白组学研究进展[J].中国医药导报,2017,14(22):55-58.
[4]温优良,罗毅卿,唐小冬,等.经皮穴位电刺激治疗脑卒中后认知功能障碍的临床随机对照研究[J].中国全科医学,2017,20(z2):12-15.
[5]丁蓓,张泳,黄娟,等.遗忘型轻度认知障碍患者脑血流灌注与认知功能的回归分析[J].放射学实践,2016,31(7):595-598.
[6]董娜,张贵丽,张宏伟.轻度认知障碍的神经心理表现及解剖结构损害的分型研究[J].中风与神经疾病杂志,2016,33(1):49-53.
[7]中华医学会神经病学分会痴呆与认知障碍学组写作组,中国阿尔茨海默病协会(ADC).中国痴呆与认知障碍诊治指南:轻度认知障碍的诊断和治疗[J].中华医学杂志,2010,90(41):2887-2893.
[8]童宣霞,王龙,周霞,等.脑萎缩对皮质下缺血性血管病患者认知功能的影响[J].中华医学杂志,2016,96(1):14-19.
[9]张宏强.针刺联合高压氧治疗脑白质疏松症伴轻度认知障碍临床观察[J].检验医学与临床,2017,14(A02):156-157.
[10]杨照玲,葛平.养血清脑颗粒治疗脑白质疏松伴轻度认知障碍患者的临床观察[J].山西医药杂志,2016,45(3):299-301.
[11]杨娟,赵晓晖,白青科,等.血清组胺与脑白质疏松症认知功能障碍的相关性[J].脑与神经疾病杂志,2016,24(6):335-338.
[12]李越秀,王金芳,沈慧聪,等.脑白质疏松症伴轻度认知损害患者静息态功能磁共振成像研究[J].中国现代神经疾病杂志,2016,16(5):264-270.
[13]郑纪平,赵伟丽,李国丽.老年急性脑梗死合并脑白质疏松症患者的认知功能障碍研究[J].临床和实验医学杂志,2014,13(2):106-109.
[14]陈红霞,郭姗姗,武一平,等.非痴呆性血管性认知障碍的研究进展[J].中国卒中杂志,2017,12(12):1148-1153.
[15]周爱红.血管性认知功能障碍防治[J].中国实用内科杂志,2016,36(11):942-946.
[16]王金芳,陈红艳,李越秀,等.脑白质疏松患者大脑功能网络小世界属性的静息态功能磁共振研究[J].中华行为医学与脑科学杂志,2017,26(11):977-982.
[17]李海涛,李桂花,哈斯也提·依不来音,等.载脂蛋白Eε4基因对轻度认知功能障碍患者脑白质微细结构损害研究[J].中国全科医学,2016,19(26):3175-3179.
[18]丁蓓,凌华威,陈克敏.轻度认知功能障碍的神经影像学研究进展[J].国外医学(临床放射学分册),2007,30(2):77-80.
[19]肖世富,陈兴时,薛海波,等.老年轻度认知功能损害的脑诱发电位变化及其发展为痴呆的预测因素[J].老年医学与保健,2005,11(4):219-222,229.