何泽佳,恽晓萍,郭华珍,等.获得性脑损伤患者执行功能的影响因素研究[J].中华物理医学与康复杂志,2021,43(11):972-977
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| 获得性脑损伤患者执行功能的影响因素研究 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.11.003 |
| 中文关键词: 执行功能 认知功能 执行功能表现测试 影响因素 获得性脑损伤 |
| 英文关键词: Executive function Cognition Performance tests Brain injury |
| 基金项目:国家重点研发计划资助（2018YFC2001700） |
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| 中文摘要: |
| 目的 探讨获得性脑损伤患者执行功能障碍的影响因素及其执行功能与其他认知功能之间的关系。 方法 选取46例获得性脑损伤患者进行执行功能表现测试（EFPT）及洛文斯顿认知成套测验（LOTCA）检查，观测指标为EFPT各任务的得分及时间，LOTCA测试中的定向力、知觉、视运动组织、思维运作检查以及注意与集中能力的得分。为探讨患者性别、年龄、受教育年限以及不同疾病特点对EFPT测试结果的影响，将46例患者分别进行分组。①按性别分为男性组与女性组；②按年龄分为青壮年组（＜40岁）和中老年组（≥40岁）；③按受教育年限分为≤12年组和＞12年组；④按不同疾病性质分为脑外伤组及脑卒中组；⑤按不同损伤部位分为左侧、右侧与双侧病灶组。然后进行各组间比较，并对性别、年龄、受教育年限及疾病性质进行多元线性回归分析，以分析不同人口统计学资料以及不同疾病特点对EFPT测试结果的影响，进而判断各因素对执行功能的影响。 结果 青壮年组的烹饪得分、服药得分及总分明显高于中老年组，青壮年组的打电话时间、服药时间及支付账单时间明显低于中老年组（P＜0.05）；受教育年限＞12年组的烹饪得分、支付账单得分、EFPT总分明显高于受教育年限≤12年组（P＜0.05）；脑外伤组的支付账单得分（Z=-2.19，P=0.03）和EFPT总分（Z=-1.69，P=0.02）明显高于脑卒中组（P＜0.05）；不同性别及不同发病部位的受试者在EFPT得分方面差异无统计学意义（P>0.05）。多元线性回归分析结果显示，EFPT总分=13.84-4.12×受教育年限+5.06×年龄+4.48×疾病性质，其中年龄的标准化回归系数β最大。除服药得分外的其他三项任务得分及EFPT总分，与LOTCA视运动组织、思维运作、注意与集中及总分呈低中度相关，相关系数绝对值范围为0.31～0.64（P＜0.05）。 结论 年龄越大，执行功能越差；受教育程度越高，执行功能越好；脑外伤对执行功能的损害程度相对脑卒中更严重；执行功能与视运动组织、思维运作及注意与集中程度有关。 |
| 英文摘要: |
| Objective To explore the factors influencing executive functioning after a brain injury and analyze the relationship between executive functioning and other cognitive functions. Methods Forty-six brain injury survivors were given the Executive Function Performance Task (EFPT) assessment and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA). The scores and time of the EFPT tasks, and the orientation, perception, visual motor organization, thinking, and attention and concentration results in the LOTCA were observed. Regression analysis compared the males and females, those younger and older than 40, those with more or less than 12 years of education, trauma and stroke survivors, as well as those with left, right and bilateral lesion to isolate the factors most influencing executive functioning. Results The average EFPT score on the cooking task, the medication score and the total score of the young group were all significantly higher than those of the older group. Their telephone time, medication time and bill payment time were all significantly shorter. Those with more than 12 years of education had average scores on the cooking, bill payment and EFPT significantly higher than those with less than 12 years of education. The average bill paying and total EFPT scores of the brain trauma group were significantly higher than the stroke group′s averages. No significant differences were observed between the different genders or those with different injury sites. Age was the strongest predictor of total EFPT scores. Except for the medication scores, the average scores of the other three tasks and the total score of EFPT were moderately correlated with the visual motor organization, thinking, attention and concentration, and total LOTCA scores, with correlation coefficients ranging from 0.31 to 0.64. Conclusions Older persons and those will less education tend to have worse executive functioning. Traumatic damage to executive functioning is more serious than that caused by stroke. Executive functioning is closely related to visual-motor organization, and to the ability to think, attend and concentrate. |
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