杜继慧

【摘要】 目的：分析急性脑梗死与认知损害的关系。方法：收集2015年7-12月内蒙古包钢医院神经内科收治的急性脑梗死患者97例，采用中文版蒙特利尔认知评估（Montreal Cognitive Assessment，MoCA）量表，在入院48 h后评价认知功能，依据认知诊断标准分为认知功能正常组与轻度认知功能损害组。结果：97例急性脑梗死患者中，认知功能正常组52例（53.6%），轻度认知功能损害组45例（46.4%）。多因素回归分析显示：额叶梗死[OR=52.4，95%CI（5.45，386.74）]增加认知损害发生风险，颞叶梗死[OR=43.7， 95%CI（6.37，438.55）]增加认知损害发生风险，丘脑梗死[（OR=36.2，95%CI（7.29，366.17）]增加认知损害发生风险；小脑梗死患者发生认知损害风险比非小脑梗死降低82%[（OR=0.18，95%CI（0.07，0.85）]，脑干梗死患者发生认知损害风险比非脑干梗死降低78%[（OR=0.22，95%CI（0.04，0.76）]；兩组顶叶、枕叶、基底节梗死患者比较，差异均无统计学意义（P>0.05）。结论：约46.4%急性脑梗死患者发生认知损害；其中额叶、颞叶、丘脑梗死增加认知损害的发生风险，顶叶、枕叶、基底节梗死与认知损害发生无显著相关。

【关键词】 脑梗死； 认知损害

【Abstract】 Objective：To analyse the relationship between acute cerebral infarction and cognitive impairment.Method：Ninety-seven patients with acute cerebral infarction were included from Inner Mongolia Baogang Hospital from July 2015 to December 2015.Montreal Cognitive Assessment was used to assess the cognitive impairment of patients with acute cerebral infarction after 48 hours of hospital admission.According to cognitive impairment diagnosis standards patients were divided into normal cognitive function group and mild cognitive impairment group.Result：Among 97 enrolled patients，52 patients（53.6%） had normal cognition，45 patients（46.4%） had mild cognitive impairment.Multivariate logistic regression analysis showed that：mild cognitive impairment in patients with frontal lobe infarction increased[OR=52.4，95%CI（15.45，386.74）]，mild cognitive impairment in patients with temporal lobe infarction increased[OR=43.7，95%CI（6.37，438.55）]，mild cognitive impairment in patients with thalamus infarction increased[OR=36.2，95%CI（7.29，366.17）]，which in patients with cerebellum infarction reduced by 82%[OR=0.18，95%CI（0.07，0.85）]，patients with brain stem infarction reduced by 78%[OR=0.22，95%CI（0.04，0.76）].Conclusion：About 46.4% patients occurred cognitive impairment after acute cerebral infarction.The frontal lobe，temporal lobe and thalam infarction increased the risk of suffering cognitive impairment，while the parietal lobe，occipital lobe and basal nucleus infarction uncorrelated with cognitive impairment.

【Key words】 Cerebral infarction； Cognitive impairment

First-authors address：Inner Mongolia Baogang Hospital，Baotou 014010，China

doi：10.3969/j.issn.1674-4985.2016.32.011

血管性认知损害是指由脑血管病危险因素、显性或非显性脑血管病所引起的从轻度认知损害到痴呆的一大类综合征[1-2]。有研究显示，脑血管病患者所有致残症状中，认知损害的发生率高达40.7%，而约30%的脑血管病存活者可能出现认知损害[3-4]。本研究初步探讨急性脑梗死与认知损害的相关性，以期为早期预防和及时治疗认知损害提供依据，现报道如下。

1 资料与方法

1.1 一般资料 收集本院神经内科2015年7-12月收治的急性脑梗死患者97例，依据认知诊断标准分为认知功能正常组与轻度认知功能损害组。脑……