不同部位脑卒中患者认知功能损害的特点分析

目的：探讨不同部位缺血性脑卒中急性期患者认知功能损害的特点。方法：收集230例脑梗死急性期（1-14天）患者,包括额叶31例,颞叶27例,顶叶26例,枕叶21例,基底节47例,丘脑35例,小脑23例,脑干20例;采用中文版蒙特利尔认知评估量表（montreal cognitive assessment,MoCA）对受试者进行认知功能测评。结果：（1）各病变部位认知障碍的发生率存在显著性差异（P〈0.05）,额叶组及丘脑组认知障碍发生率最高,达90%以上,其次为颞叶组,达到80%以上,小脑组及脑干组最低,约30%左右。（2）额叶组在视空间与执行功能、注意认知域分值低于其他各组（P〈0.05）;颞叶组在命名、延迟回忆认知域分值低于其他各组;顶叶组及枕叶组MoCA总分分值低于基底节、小脑、脑干组（P〈0.05）;丘脑组不仅在视空间与执行功能、注意认知域得分低于顶叶、枕叶、基底节、小脑和脑干组,且其语言及定向认知域分值低于其他各组（P〈0.05）。结论：不同部位脑梗死患者认知障碍的发生率及认知功能损害的特点不同。

Analysis on the Characteristics of Cognitive Impairment of Different Parts of the Stroke Patients

Objective： To explore the characteristics of cognitive impairment of the patients with different parts ofischemic stroke in acute phase. Methods： 230 cases of acute cerebral infarction （1-14 days） patients were collected, including 31 cases of frontal lobe, 27 cases of temporal lobe, 26 cases of parietal lobe, 21 cases of occipital lobe, 47 cases of basal ganglia, 35 cases of thalamus, 23 cases of the cerebellum and 20 cases of brain stem. The cognitive function for all subjects were evaluated by using the Chinese version of Montreal Cognitive Assessment Scale. Results： （1） The incidence of cognitive impairment for different position of ischemic stroke was significantly different（p〈0.05）, which was highest in frontal group（〉90%） and lowest in cerebellum group and brain stem group, temporal lobe group took second place （〉80%）. （2）The scores of frontal group in visuospatial and executive fimction and attention aspects were lower than those of other groups （P〈0.05）, naming and delayed recall aspects in temporal lobe group had a lower score as compared with other groups; the MOCA scores in parietal and occipital groups were lower than that in the basal ganglia, cerebellums and brainstem groups （P〈0.05）; the scores of thalamus group was not only lower than that of parietal lobe, occipital lobe, basal ganglia, cerebellum and brainstem groups in visuospatial and executive fimction and attention aspects, but also had a lower score in language and Orientation cognitive domain aspects as compared with any other groups （P〈0.05）. Conclusions： The incidence and characteristics of cognitive impairment was different for different parts of the cerebral infarction patients.