| 缺血性脑白质病变与认知功能损害关系的研究 |
| Alternative Title | Research of Relationship between Ischemic White Matter Lesions and Cognitive Impairment
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| 吕文明 |
| Thesis Advisor | 瞿学栋
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| 2014-05-27
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 脑缺血
白质病变
认知功能
MMSE
MoCA
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| Abstract | 目的 探讨不同程度、不同部位的缺血性脑白质病变对认知功能的影响及其相关关系。
方法 2012年10月至2013年11月于兰州大学第二医院神经内科就诊者，根据其颅脑磁共振检查结果，选取缺血性脑白质病变（white mater lesion，WML）患者90例，正常对照组35例。将WML患者根据病变部位不同为深部脑白质病变组（deep white matter lesions, DWML）、近脑室旁白质病变组（periventricular lesion, PVL）及混合组；应用Fazakas量表评价WML的严重程度，据此将WML患者分为三组（轻度、中度及组度组），并结合MMSE、MoCA量表对入选患者和正常对照者进行认知功能评价，分析不同程度、不同部位WML对认知功能的影响并进行相关分析。
结果 与正常对照组比较，WML不同程度组MMSE、MoCA量表总分及视空间与执行功能、延迟回忆评分均显著降低，差异均有统计学意义（均P＜0.05），WML重度组除抽象思维能力外，MoCA量表其余6项认知域评分均明显降低（均P＜0.05）；WML严重程度的Fazekas评分与MMSE和MoCA评分均呈负相关（r=-0.780，-0.817,均P＜0.05）；DWML组在视空间与执行功能和语言表达评分低于PVL组和对照组，差异有统计学意义（均p＜0.05）；PVL组的延迟回忆、注意力及计算力方面评分低于DWML组和对照组，差异有统计学意义（均p＜0.05）；混合组在除抽象功能以外的其余6项认知功能评分低于对照组，差异有统计学意义（均p＜0.05）。
结论 缺血性脑白质病变可导致认知功能损害，脑白质病变程度越重，认知下降越显著；脑室旁和深部白质病变对不同认知域损害不同。 |
| Other Abstract | Objective To investigate the impacts of ischemic white matter lesion of the patients in different extents and locations on cognitive function and its correlation.
Methods Ninety patients with ischemic white matter lesion and thirty –five gender—matched healthy subjects were recruited from the Department of Neurology and those admitted to the Second Hospital of Lanzhou University from October 2012 to November 2013. According to MRI, ninety patients with white matter lesion were first classified into 3 subgroups (deep white matter lesions、periventricular lesions and mixed regions) depending on the location, then were classified into 3 subgroups (mild、moderate、 severe)depending on the degree. All participants underwent neuropsychological tests by using the Mini-Mental state Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The impact of different extents and locations of white matter lesion on cognitive function was assessed by statistical analysis.
Results Compared with control group, WML in different degree groups had significantly lower scores in total MMSE and MoCA scores, visual spatial , executive function and delayed memory ability(P＜0.05). In severe groups, the scores of MoCA individual cognitive components decreased significantly except the function of abstractions(P＜0.05) ; Correlation analysis showed that the severity of WML had a negative correlations with the performance of MoCA and MMSE(r=-0.780,-0.817P＜0.05) . The scores of executive function and language in DWML group were lower than in PVL and control group(p＜0.05). PVL group had significantly lower scores in delayed memory and attention compared with DWML and control groups(P＜0.05). In mixed regions group , the scores of MoCA individual cognitive components decreased significantly except the functions of abstractions compared with control group(P＜0.05) .
Conclusions The WML patients with small vessel disease undergo cognitive impairment of different degree. The more serious of white matter lesion, the more significant decline in cognitive function. PVL and DWML have different impacts on cognitive function. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/222820
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
吕文明. 缺血性脑白质病变与认知功能损害关系的研究[D]. 兰州. 兰州大学,2014.
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