短暂性脑缺血发作及轻型卒中患者认知功能下降的随访研究  

The follow-up study of mid-term cognitive decline among Chinese TIA/minor stroke cases

作　　者：杨洁[1] 区腾飞[2] 解龙昌[1] 殷建瑞[1] 蒲蜀湘[1] 杨新光[1] 何毅华[1] 姚海燕[1] 高聪[1] 

机构地区：[1]广州医科大学附属第二医院神经内科,广州510260 [2]佛山市第二人民医院神经内科

出　　处：《中国神经精神疾病杂志》2015年第2期98-101,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：广州医科大学博士启动基金(编号:2012C84)

摘　　要：目的既往的研究对短暂性脑缺血发作(transient ischemic attack,TIA)及轻型卒中后的认知功能障碍的关注较少。我们将对此类患者发生认知功能障碍的危险因素进行探讨。方法我们筛选了2012年7月至12月期间,连续住院的TIA及轻型卒中患者。于发病后第3个月及第18个月各进行一次认知功能评估,截止至2014年3月31日。结果共209例TIA及轻型卒中患者入组。其中,共24例(11.5%)出现了认知功能显著下降。Logistic回归分析,结果显示:受教育年限(比数比OR=0.869,P=0.021),心房纤颤(OR=5.950,P=0.001)、多发性腔隙性脑梗死(OR=5.179,P=0.020)是TIA/轻型卒中患者中远期认知功能下降的独立危险因素。结论对于TIA/轻型卒中的患者有必要对其认知功能进行随访,对于有心房纤颤及颅内多发性腔隙性脑梗死的患者应关注其认知功能变化,加强随访,必要时尽早给予干预治疗措施,以减少其发生认知功能下降的风险。Objetive The present study was aimed to explore the risk factors of mid-term cognitive decline in pa-tients with indexed TIA/minor stroke（NIHSS≤3） in a Chinese hospital-based cohort.MethodsWe recruited all consec-utive Chinese TIA/minor stroke patients from July to December in 2012 and followed them up in stroke clinics at 3 and18 months after indexed TIA/minor stroke. The outcome was defined as significantly cognitive decline at 18 months com-pared with that at 3 months.ResultsA total of 209 consecutive Chinese TIA/minor stroke cases completed their fol-low-up investigation. Among them, 24（11.5%） exhibited significantly cognitive decline. The independent risk factors ofcognitive decline post TIA/minor stroke were education years（OR=0.869,P=0.021）, atrial fibrillation（OR=5.950, P=0.001） and multiple silent lacunar infarcts（OR=5.179,P=0.020）.ConclusionIt is necessary to evaluate the cognitionamong TIA/minor stroke cases and a close follow-up is required for patients with atrial fibrillation and multiple silent la-cunar infarcts frequently in order to decrease the risk of cognitive decline post TIA/minor stroke.

关 键 词：短暂性脑缺血发作 轻型卒中 认知功能下降 

分 类 号：R743.3[医药卫生—神经病学与精神病学]