缺血性脑卒中后血管性认知功能损害的临床特征及影像学研究  

Study on clinical characters and image features in patients with vascular cognitive impairment after ischemic stroke

作　　者：覃莲[1] 黄进瑜[1] 廖宝共[1] 毛珍芳[1] 韦菁[1] 

机构地区：[1]广西柳州医学高等专科学校第一附属医院神经内科,广西柳州545002

出　　处：《中国现代医学杂志》2008年第16期2398-2401,共4页China Journal of Modern Medicine

基　　金：广西区卫生厅自筹基金科研项目;合同号Z2005207

摘　　要：目的研究缺血性脑卒中后认知功能损害患者的临床特征及影像学特点。方法2005年2月～2006年11月收治急性缺血性脑卒中患者120例,其中认知正常62例、血管性认知障碍无痴呆组(CIND)58例,研究两组人口学特征、中风危险因子、血清学、日常生活能力(BI)评分、头颅CT和(或)MRI影像学等资料。结果单因素分析显示教育水平、年龄、心脏病、高血糖、左侧大脑半球病变、颞叶病变、病灶大小、静息病灶数、脑萎缩、脑白质疏松、BI评分、丘脑病变及陈旧病灶数与认知功能损害有关(P<0.05,P<0.01);多变量回归分析显示病灶大小、丘脑部位病变、陈旧病灶数目、急性期高血糖、年龄与认知功能损害明显相关,OR值(95%CI)分别为8.32(8.32～24.50)、6.39(2.46～16.62)、2.54(1.03～6.25)、1.53(1.05～2.23)、1.12(1.05～1.20)。结论病灶大小、丘脑部位病变、陈旧病灶数目、高血糖、年龄与缺血性脑卒中认知功能损害相关,可能是独立危险因素。[Objective] To study the clinical characters and imaging features in patients with vascular cognitive impairment after ischemic stroke. [Methods] There are 120 patients who were treated in our hospital for acute ischemic stroke from February 2005 to November 2006. Compared with 62 patients who were normal cognition ,58 patients of CIND were found to exist vascular cognitive impairment at 3 month after stroke. The study variable included the demographic characters, vascular risk factors ,laboratory parameters, barthel index scores and the brain CT/MRI scan. [Results] Single variable analysis showed that there were differences between two groups in education level, cardiopathy, high level glucose, left hemisphere, infart location, infart size silence, old infarts, brain atrophy, white matter lesions and low BI scores （P〈0.05, P〈0.01）. Multivariable logistic regression analysis found that infarct size, injured site at thalamus, old lesions, age, high level glucose were independent risk factors of vascular cognitive impairment after ischemic stroke. The OR （95 confidentce interval, 95%CI）was 8.32（8.32～24.50）, 6.39 （2.46～16.62）, 2.54 （1.03～6.25）, 1.53 （1.05～2.23）, 1.12 （1.05～1.20） respectively. [Conclusions] This study suggested that infarct size, injured site at thalamus, old lesions, age and high level glucose were the independent risk factors of vascular cognitive impairment.

关 键 词：缺血性脑卒中 血管性认知功能障碍 临床特征 影像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]