【作者】 卜范艳；

【导师】 任艳；

【作者基本信息】 中国医科大学 ， 神经病学， 2010， 硕士

【摘要】 目的探讨脑分水岭梗塞的临床特点及对其认知功能的影响。方法收集住院患者经MRI诊断为脑分水岭梗塞35例患者的临床资料,将脑分水岭梗塞分为皮质前型、皮质后型、皮质下型和混合型,对各型梗塞的临床特点进行分析；应用CTA检查手段对其中11例患者血管情况进行评估；同时选取同时期住院无脑梗塞的患者15例作为对照组,对两组进行MMSE和MoCA评分,应用SPSS15.0统计学软件,对两组进行统计分析。结果在各类型的脑分水岭梗塞中,皮质下型最常见,占脑分水岭梗塞的48.57%；11例血管CTA检查结果显示9例(81.82%)为皮质下型梗塞,11例均有不同程度的颅内外血管狭窄,颅内血管狭窄以大脑中动脉最常见；分水岭梗塞对认知功能有不同程度的影响,MoCA较MMSE能更敏感的反应认知功能的变化,行MMSE评分,梗塞组与非梗塞组之间无统计学意义(P>0.05),行MoCA评分,梗塞组与非梗塞组之间有统计学意义(P<0.005),在MoCA量表中,两组之间比较,其中视空间及执行功能、注意力、延迟记忆三项对比均有统计学意义(P<0.005),而语言、命名、抽象和定向力四项两组之间无统计学意义(P>0.05)。结论分水岭梗塞有其特有临床特点；对认知功能有影响；MoCA能更敏感的反应认知功能的变化。更多还原

【Abstract】 ObjectiveTo investigate the clinical manifestation of Cerebral Watershed infarction (CWI) and the impact on cognitive function.Methods35 patients with CWI diagnosed by magnetic resonance imaging(MRI) were collected and were divided into anteral watershed infarction (AWSI), posterior watershed infraction (PWSI), internal watershed infarction(IWSI) and mixed watershed infarction(MWI). Our job is to analysis the clinical feature of each pattern, and to evaluate blood vessel condition of 11 patients using CTA. Meanwhile, choose control group without cerebral infarction, Using MMSE and MoCA to compare the two groups under the help of SPSS 15.0.ResultPosterior watershed infarction is the most common pattern in our research; account for 48.57%; 11 patients taked CTA all show hemadostenosis in both intracranial and extracranial artery. And it indeed have some impact on cognitive function.MoCA is more sensitive than MMSE in detecting mild changes of cognitive function,the two groups have significant difference(P<0.005). In MoCA, vision vacuity and execution function, attention and delayed memory have statistically significant(P<0.005), except speech, naming, abstract and orientation force.ConclusionCWI has its own feature, and have some impact on cognitive function. MoCA is more sensitive than MMSE in detecting mild cognitive impairment.更多还原