中文摘要：

目的探讨腔隙性脑梗死（1acunarinfarction，L1）患者认知损害的影响因素，分析不司部位LI患者的认知损害特征。方法纳入LI患者和正常对照者。采用简易智能状态检查量表（Mini—MentalStatusExamination，MMSE）评价认知损害。采用加利福尼亚语言学习测试（CaliforniaVerbalLearningTest，CVLT）、言语流畅性测验（VerbalFluencyTest，VFT）、Benton线方向判断（BentonJudgmentofLineOrientationTest，BJLOT）、数字符号编码测验（DigitSymbol—Codingsubtest，DSCT）、定步调听觉连续加法测验（PacedAuditorySerialAdditionTest，PASAT）、威斯康星卡片分类测验（WisconsinCardSortingTest，WCST）评价注意力、信息处理速度、记忆力、语言流畅性和执行功能。结果共纳入98例LI患者和20例正常对照者。在98例LI患者中，31例存在认知损害，67例认知正常。认知损害组高血压、糖尿病、多发性LI和重度脑白质病变的患者构成比以及低密度脂蛋白胆固醇水平均显著性高于认知正常组（P均〈0．05）。多变量logistic回归分析显示，高血压[优势比（oddsratio，OR）5．391，95％可信区间（confidenceinterval，CI）1．515～19．182；P=0．009]、糖尿病（OR4．679，95％CI 1．428～15．339；P=0．011）、多发性LI（OR6．458，95％CI1．797～23．213；P=0．004）和重度脑白质病变（OR6．724，95％CI1．440～27．331；P=0．014）是LI患者发生认知损害的独立危险因素。在98例LI患者中，共有56例为单纯腔隙性梗死（无脑白质病变），但其中5例因不能配合完成神经心理测试而排除，最终51例被纳入与正常对照组进行对比分析。与对照组相比，放射冠／半卵圆是心组（n=15）WCST-64正确应答数显著性减少，持续错误数显著性增多（P〈0．05）；基底节组（n=20）言语流畅性、DSCT、PASATN试得分以及WCST-64正确应答数和完成分类数均显著性降低（P均〈0．05）；丘脑组

英文摘要：

Objective To investigate the influencing factors of cognitive impairment in patients with lacunar infarction （LI） and to analyze the features of cognitive impairment at different parts in patients with LI. Methods Patients with LI and normal controls were enrolled in the study. Mini-Mental Status Examination （MMSE） was used to evaluate cognitive impairment. California Verbal Learning Test （CVLT）, Verbal Fluency Test （VFT）, Benton Judgment of Line Orientation Test （BJLOT）, Digit Symbol-Coding subtest （DSCT）, Paced Auditory Serial Addition Test （PASAT）, and Wisconsin Card Sorting Test （WCST）were used to evaluate attention, information processing speed, memory, verbal fluency, and executive function. Results A total of 98 patients with LI and 20 normal controls were enrolled. Of the 98 patients with LI, 31 had cognitive impairment and 67 were cognitively normal. The proportions of hypertension, diabetes, multiple LI, and severe white matter lesions, as well as the level of low-density lipoprotein cholesterol in the CI group were significantly higher than those in the normal controls （all P〈 0. 05）. Multivariate logistic regression analysis showed that hypertension （odds ratio [ ORI 5.391, 95% confidence interval[CI] 1.515-19. 182; P=0.009）, diabetes （OR 4.679, 95% CI 1.428-15.339; P=0.011）, multiple LI （OR 6. 458, 95% CI 1. 797 -23. 213; P=0. 004）, and severe white matter lesions （OR 6. 724, 95% CI 1. 440-27. 331; P= 0. 014） were the independent risk factors for the occurrence of cognitive impairment in patients with LI. Among the 98 patients with LI, 56 were pure LI （no white matter lesions）, but 5 of them were excluded because they could not complete neuropsychological tests. Finally, 51 patients were enrolled and were compared and analyzed with the normal control group. Compared to the normal eontrol group, the number of correct answers of WCST-64 in the corona radiata/semi-oval center group （n = 15） reduced significantly, and the number of sustained e