Objective To investigate the neuropsychological features of vascular cognitive impairment(VCI) of first cerebral infarction. Method The cognitive function statuses and daily living abilities in 50 normal persons (control group)and 70 patients with cerebral infarction for the first time(case group)were evaluated by Montreal Cognitive Assessment(MoCA)and revised scale of activities of daily living(ADL)at 3 months after onset,and the MoCA and ADL scores at different infarction sites were analyzed. Results The case group had significantly lower MoCA and ADL scores than those of the control group(P＜0.05). Of the case group, MoCA score was＜23 points in 43 patients (61.4%). The case group and control group had significantly different visuospatial abilities,executive functions, attentions,and abstract thinking abilities(all P＜0.05).The group with infarction at cortex had a significantly lower ADL score than the group with infarction at internal capsule zone of basal ganglia(P＜0.05);while the two groups had insignificantly different MoCA scores. Conclusion VCI and daily living ability decrease after cerebral infarction have high incidences; the former is mainly manifested by impaired executive function, attention,and abstract thinking ability. VCI secondary to infarctions at internal capsule zone of basal ganglia and cortex has a higher incidence than that at the other sites,and patients with infarction at cortex have severer daily living ability impairment than those with infarction at internal capsule zone of basal ganglia.%目的 探讨首次脑梗死后血管性认知功能损害(CVI)的神经心理学特点.方法 以蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)和日常生活活动能力量表(activity of daily living scale,ADL)修订版为神经心理学检测量表,评估70例首次脑梗死患者起病后3个月(病例组)和50例正常者(对照组)的认知功能状态和日常生活能力,并分析不同梗死部位的MoCA和ADL得分.结果 病例组MoCA、ADL分值较对照组明显下降,差异有统计学意义(P＜0.05),病例组中43例(61.4%)MoCA＜23分;病例组与对照组比较,视空间与执行、注意力、抽象思维能力有显著差异(均P＜0.05);皮质脑梗死组ADL得分较基底核内囊区脑梗死组低,差异有显著性(P＜0.05);MoCA得分无明显差异.结论 脑梗死后血管性认知功能减退及日常生活能力下降发生率较高,认知功能减退主要表现为执行功能﹑注意力及抽象思维能力的损害,基底核内囊区与皮质梗死CVA发生率较其他部位高,皮质梗死患者日常生活能力受损较基底核内囊区梗死患者突出.
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