脑白质病变与轻度认知功能障碍的关系

摘要

Objective To explore the relationship between the white matter lessions(WML) and mild cognitive impairment (MCI).Methods Seventy-one WML patients were divided into mild group (27 cases),moderate group (21 cases) and severe group (23 cases) according to the head MRI examination,and 39 cases of no WML were control group.All the subjects were evaluated with the neuropsychological scale.The prevalence rate of MCI in each group was compared,and the relationship between WML and MCI was analyzed.Results The prevalence rate of MCI in WMI mild,moderate and severe groups were significantly higher than that in control group(all P ＜ 0.01).The scores of the mini-mental state examination (MMSE) and Montreal cognitive assessment scale (MoCA) in moderate and severe groups were significantly lower than those in the mild group and control groups (all P ＜ 0.01).The scores of MoCA individual cognitive components decreased significantly except the function of abstraction as the lesions grade of WML increased(all P ＜ 0.05).The multiple linear correlation analysis showed that degree of WML and scores of MMSE,MoCA and each cognitive domain scores except the function of abstraction were negatively correlated (r =-0.252--0.782,all P ＜ 0.01).Conclusion WML can lead to MCI.The effect of WML on cognitive dysfunction is related to its lesions grade.%目的 探讨脑白质病变(WML)与轻度认知功能障碍(MCI)的关系.方法 71例WML患者根据头颅MRI检查分为轻度组(27例)、中度组(21例)、重度组(23例),39例无WML的对照者为对照组.对入组者进行神经心理学量表检查；比较各组MCI的患病率,分析WML与MCI的相关性.结果 WML轻、中、重度组的MCI患病率明显高于对照组(均P＜0.01)；WML中、重度组简易精神状态检查(MMSE)及蒙特利尔认知评估量表(MoCA)评分显著低于WML轻度组和对照组(均P＜0.01)；随着WML程度的加重,除了抽象能力评分,MoCA其他各认知领域的评分均显著降低(均P＜0.05).多元线性相关分析显示,WML程度与MMSE、MoCA总分及除抽象思维能力的各认知域评分呈负相关(r=-0.252 ～-0.782,均P＜0.01).结论 WML可导致MCI,其对认知功能障碍的影响与WML的程度有关.