中华老年心脑血管病杂志

目的　探索老年普遍性脑萎缩者不伴痴呆的轻微认知功能障碍 (MCI)发生情况及相关因素 ,为提高普遍性脑萎缩者认知功能 ,防治痴呆提供一些线索。方法　将CT确诊的老年普遍性脑萎缩者 ,经简易智能量表 (MMSE)、临床痴呆评定量表 (CDR)测定及参照DSM Ⅳ痴呆诊断标准除外痴呆的 10 0例观察对象分为无认知障碍和轻微认知障碍组 ,确定明显萎缩部位 ,经个人史、既往史问卷及血脂、血流变检查 ,对所得资料进行单因素及多因素logistic回归分析 ,明确所观察指标与老年普遍性脑萎缩者轻微认知障碍的关系。结果　普遍性脑萎缩的老年人MCI发生率为 2 3%。单因素t检验或卡方检验示年龄、文化程度、高血压史、高血脂史、一过性脑缺血 (TIA)发作史及皮层下萎缩与老年普遍性脑萎缩者轻微认知障碍相关 (P <0 .0 5 ) ,logistic回归分析表明TIA史 (OR 4 .15 3,P <0 .0 5 )、高甘油三酯 (OR 4 .4 6 3,P <0 .0 5 )、皮层下萎缩 (OR 6 .94 7,P <0 .0 5 )和文化程度 (OR 0 .12 0 ,P <0 .0 5 )为相对独立的危险因素。结论　TIA和高甘油三酯为老年普遍性脑萎缩者轻微认知障碍的明显危险因素 ,降低血脂、防治TIA、改善脑供血对提高老年普遍性脑萎缩者认知功能、防治痴呆有积极的意义

Objective To investigate the incidence and factors contributing to the mild cognitive impairment (MCI) related to general cerebral atrophy of senile people.Methods According to the criteria of mini mental state examination(MMSE),clinical dementia rating (CDR) and DMS Ⅳ R,100 old persons with general cerebral atrophy without cognitive impairment or with MCI but no dementia were admitted to this study.Standardized questionnaires on personal history and medical history,neurological examination,and blood tests were carried out.Chi square test,student t test and logistic regression analysis were performed on the basis of the data. Results Prevalence rate of MCI in the aged with general cerebral atrophy was 23%.TIA,hyperlipemia,subcortical atrophy,and level of education were the major determinants of MCI in elderly with general cerebral atrophy.Conclusions Hypertriglyceridemia and TIA are the most important factors contributing to MCI in elderly with general cerebral atrophy.Control of the blood lipid and prevention of TIA are important for improving the cognitive function of the aged.