[1]郭燕,李娟,陈俊.脑小血管病负担评分与卒中患者认知功能障碍的关系[J].陕西医学杂志,2025,54(10):1381-1385.[doi:DOI:10.3969/j.issn.1000-7377.2025.10.015]
　GUO Yan,LI Juan,CHEN Jun.The relationship between cerebral small vessel disease burden score and cognitive impairment in stroke patients[J].,2025,54(10):1381-1385.[doi:DOI:10.3969/j.issn.1000-7377.2025.10.015]
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脑小血管病负担评分与卒中患者认知功能障碍的关系

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年10期
页码:
1381-1385
栏目:
临床研究
出版日期:
2025-10-05

文章信息/Info

Title:
The relationship between cerebral small vessel disease burden score and cognitive impairment in stroke patients
作者:
郭燕; 李娟; 陈俊
（南京脑科医院，江苏 南京 210029）
Author(s):
GUO Yan; LI Juan; CHEN Jun
（Nanjing Brain Hospital,Nanjing 210029,China）
关键词:
脑小血管病; 卒中; 认知功能障碍; 蒙特利尔认知评估量表; 磁共振成像
Keywords:
Cerebral small vessel disease; Stroke; Cognitive impairment; MoCA score; MRI
分类号:
R 743.3
DOI:
DOI:10.3969/j.issn.1000-7377.2025.10.015
文献标志码:
A
摘要:
目的：探究脑小血管病总体负荷与门诊卒中患者认知功能障碍之间的关联特征，并评估其预测效能。方法：研究纳入296例神经内科门诊初诊卒中患者进行回顾性分析，基于磁共振影像学特征构建脑小血管病负荷评分系统，将受试者划分为高负荷与低负荷队列。认知功能评估采用蒙特利尔认知评估量表，阈值设定为26分作为认知损伤临界值。采集人口统计学资料、共病信息及神经功能缺损量表评分等协变量数据，运用单因素与多因素回归模型解析认知损伤相关因素，通过受试者工作特征曲线验证负荷评分的预测效能，并进行亚组稳定性检验。结果：显示高负荷组认知损伤发生率高达91.2%，与对照组51.2%比较有统计学差异（P<0.001）。基线资料中年龄、性别构成、教育背景、神经功能缺损程度及共病分布均保持组间均衡。高负荷组在总体认知评分及各子领域（注意维持、执行控制、情景记忆、时空定向、抽象推理）均表现出更严重的功能损害（均P<0.001）。多元回归模型显示高脑小血管病负荷（OR=10.93，95%CI：4.62~25.86）与神经功能缺损程度（OR=0.62，95%CI：0.43~0.90）构成独立预测因子。负荷评分预测认知损伤的曲线下面积达0.817，各亚组验证中曲线下面积均超过0.78，展现稳定的判别效度。结论：CSVD负荷与门诊卒中患者的认知障碍密切相关，CSVD评分不仅可反映患者的认知状态，更可作为门诊卒中后认知障碍的有力预测工具，具有较高的临床实用价值。
Abstract:
Objective:This study aims to explore association between cerebral small vessel disease (CSVD) burden and cognitive impairment in outpatient stroke patients,and evaluate predictive performance of CSVD burden score.Methods：Conducting retrospective analysis of 296 newly diagnosed stroke patients in neurology outpatient department.Establish CSVD burden scoring system based on magnetic resonance imaging (MRI) features,divide subjects into high-burden group and low-burden group.Use Montreal Cognitive Assessment (MoCA) for cognitive function evaluation,set 26 points as cognitive impairment threshold.Collect demographic data,comorbidities and neurological deficit scores as covariates,analyze cognitive impairment related factors through univariate and multivariate regression models,use receiver operating characteristic curve (ROC) to verify burden score predictive performance and conduct subgroup stability test.Results:Cognitive impairment incidence in high-burden group reaches 91.2%,significantly higher than 51.2% in low-burden group (P<0.001),baseline characteristics of two groups maintain good balance in age,gender composition,education years,neurological deficit degree and comorbidity distribution.High-burden group shows significantly more severe impairment in cognitive domains including attention,executive control,episodic memory,spatial orientation and abstract reasoning (all P<0.001).Multivariate regression shows high CSVD burden (OR=10.93,95%CI：4.62-25.86) and neurological deficit degree (OR=0.62,95%CI：0.43-0.90) as independent predictors of cognitive impairment.ROC curve area under curve for burden score predicting cognitive impairment reaches 0.817,discriminant validity remains stable across subgroups (AUC>0.78).Conclusion:CSVD burden is closely associated with cognitive impairment in outpatient stroke patients.The CSVD burden score not only reflects cognitive status but also serves as a robust predictive tool for cognitive impairment post-stroke,demonstrating high clinical utility.

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备注/Memo

备注/Memo:
江苏省科技计划项目（SBE2019750135）
更新日期/Last Update: 2025-10-09