血管性认知障碍的诊断和治疗

V. V. Zakharov
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引用次数: 2

摘要

认知障碍(CI)通常是脑血管疾病最早和最普遍的表现。脑卒中后认知障碍的临床表现可能因血管病变部位的不同而不同,因此认知障碍发病与脑卒中事件在时间上的适当关联具有最重要的诊断价值。非脑卒中(皮层下)变异型脑血管病通常与小血管疾病有关。皮层下变异型 CI 的特点是注意力和执行功能缺失,经常合并情绪障碍、姿势不稳和额叶源性步态障碍。血管性 CI 意味着必须彻底控制血管风险因素(动脉高血压、血脂异常、糖尿病等)。处方中的促血管生长药具有致病作用。本文介绍了尼麦角林治疗不同严重程度血管性 CI 患者的临床经验。
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Diagnosis and treatment of vascular cognitive disorders
Cognitive impairment (CI) usually is the earliest and most prevalent manifestation of cerebral vascular disease. Post stroke CI may have different clinical presentation depending on location of vascular lesion, so appropriate temporal association of CI onset with the event of stroke is of most important diagnostic value. Non-stroke (subcortical) variant of cerebral vascular disease usually is associated with small vessel disease. CI in subcortical variant is characterized with attention and executive functions deficit, frequently in combination with emotional disorders, postural instability and gait disturbances of frontal origin. Presence of vascular CI means essential need of thorough vascular risk factor (arterial hypertension, dyslipidemia, diabetes etc.) control. Vasotropic agents are prescribed with pathogenic purposes. The article presents clinical experience of nicergoline treatment of patients with vascular CI of different severity.
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