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[单眼失明的认知影响及相关影响因素分析]

[Analysis of the cognitive effects of monocular blindness and related influencing factors].

作者信息

Ding J W, Dong J, Dong L, Qu X X, Xian J F, Li D M

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China.

Medical Imaging Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2022 Jan 11;58(1):41-45. doi: 10.3760/cma.j.cn112142-20210108-00009.

Abstract

To investigate the cognitive effects of monocular blindness and related influencing factors. A cross-sectional study was conducted. The patients with monocular blindness (the age of onset <16 years) were enrolled from Beijing Tongren Eye Center, Beijing Tongren Hospital between January 2018 and June 2020. The Montreal cognitive assessment (MoCA) scale was applied to assess seven cognitive domains including visuospatial and executive function, naming, attention, etc. Based on MoCA scores, all the patients were classified into two groups: normal cognitive functions and cognitive impairment. Spearman's correlation was used to perform the single factor analysis of the influencing factors of cognitive functions. Multivariate linear regression analyses were applied to identify the independent influencing risk factors. A total of 45 patients with monocular blindness were enrolled. There were 25 males and 20 females, with age at testing being (27±10) years.The incidence of cognitive impairment in 45 patients was 60.0% (27/45). The abnormal items ranking from a high to low rate were language (95.6%, 43 cases), delayed recall (75.6%, 34 cases), visuospatial and executive function (60.0%, 27 cases), abstract (44.4%, 20 cases), attention (35.6%, 16 cases), naming (20.0%, 9 cases), and orientation (0%). There were statistically significant differences (all <0.05) in total score (21.9±3.3 . 27.4±1.4), visuospatial and executive function (3.2±1.7 . 4.6±0.7), naming (2.7±0.6 . 2.9±0.2), attention (5.3±1.0 . 5.8±0.4), language (1.1±0.8 . 1.8±0.8), abstract (1.1±0.8 . 1.8±0.5) and delayed recall (2.3±1.3 . 4.4±0.8) between two groups of patients with and without cognitive impairment. Spearman's correlation analysis showed visuospatial and executive functions, attention, abstract and MoCA total score were positively correlated with education years (correlation coefficients being 0.355, 0.424, 0.434 and 0.370, respectively; all <0.05). Multiple linear regression showed that duration of blindness was correlated with naming (β=-0.325), and years of education correlated with attention (β=0.472), abstract ability (β=0.441) and MoCA total score (β=0.390) (all <0.05). Monocular blindness may affect language, delayed memory and visuospatial executive functions. The duration of blindness is an independent risk factor, and higher education is a protective factor of the cognitive impairment.

摘要

为探讨单眼盲的认知影响及相关影响因素。进行了一项横断面研究。2018年1月至2020年6月期间,从北京同仁医院北京同仁眼科中心招募单眼盲患者(发病年龄<16岁)。应用蒙特利尔认知评估(MoCA)量表评估包括视觉空间与执行功能、命名、注意力等七个认知领域。根据MoCA评分,将所有患者分为两组:认知功能正常和认知障碍。采用Spearman相关性分析对认知功能的影响因素进行单因素分析。应用多因素线性回归分析确定独立的影响危险因素。共纳入45名单眼盲患者。其中男性25名,女性20名,测试时年龄为(27±10)岁。45例患者中认知障碍的发生率为60.0%(27/45)。异常项目发生率从高到低依次为语言(95.6%,43例)、延迟回忆(75.6%,34例)、视觉空间与执行功能(60.0%,27例)、抽象能力(44.4%,20例)、注意力(35.6%,16例)、命名(20.0%,9例)和定向(0%)。认知功能正常组与认知障碍组在总分(21.9±3.3 、27.4±1.4)、视觉空间与执行功能(3.2±1.7 、4.6±0.7)、命名(2.7±0.6 、2.9±0.2)、注意力(5.3±1.0 、5.8±0.4)、语言(1.1±0.8 、1.8±0.8)、抽象能力(1.1±0.8 、1.8±0.5)和延迟回忆(2.3±1.3 、4.4±0.8)方面差异均有统计学意义(均<0.05)。Spearman相关性分析显示,视觉空间与执行功能、注意力、抽象能力与MoCA总分均与受教育年限呈正相关(相关系数分别为0.355、0.424、0.434和0.370;均<0.05)。多因素线性回归显示,失明持续时间与命名相关(β=-0.325),受教育年限与注意力(β=0.472)、抽象能力(β=0.441)和MoCA总分(β=0.390)相关(均<0.05)。单眼盲可能影响语言、延迟记忆和视觉空间执行功能。失明持续时间是独立危险因素,较高的受教育程度是认知障碍的保护因素。

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