牙齿缺失对急性缺血性卒中患者认知功能障碍影响的临床研究  

Clinical Research on Tooth Loss and Vascular Cognitive Impairment in Acute Stroke

作　　者：唐爱群 朱瑾华[2] 朱飞奇[2] 

机构地区：[1]广东省深圳市罗湖区干部保健委员会办公室,广东深圳518023 [2]汕头大学医学院附属粤北人民医院神经内科,广东汕头525000

出　　处：《河北医学》2015年第7期1103-1107,共5页Hebei Medicine

摘　　要：目的：探讨牙齿缺失对急性缺血性卒中后认知功能障碍的影响。方法：选择2011年10月至2012年6月在汕头大学医学院附属粤北人民医院神经内科住院的急性期缺血性卒中患者共190例,采集患者的人口学资料、既往病史和牙齿缺失等情况,检测血脂、血糖、同型半胱氨酸、超敏C反应蛋白（hypersensitivity C-reactive protein,hs-CRP）、白细胞、纤维蛋白原、肌酐等血清学指标,患者入院3d内完成美国国立卫生研究院卒中量表（National Institute of Health stroke scale,NIHSS）评分和中文蒙特利尔认知评估量表（Montreal Cognitive Assessment,Mo CA）评分测定。采用t检验或秩和检验比较各组变量指标,组间频率比较采用卡方检验,并行Logistic回归分析,以P〈0.05差异有统计学意义。结果：血管性认知功能障碍（vascular cognitive impairment,VCI）相关因素的Logistic回归分析显示,单因素分析表明年龄、受教育水平及收入水平低和缺牙数多（缺失≥8比≤7颗）与VCI的发生显著相关（P〈0.01）,体重指数、既往缺血性卒中及糖尿病史、同型半胱氨酸和hs-CRP也与VCI的发生相关（P〈0.10）。但是多因素分析结果表明缺牙≥8颗（OR=8.5,95%CI：2.6~28.6,p=0.001）与缺失≤7颗比,低收入水平（OR=62.7,95%CI：3.9~1018.1,p=0.007）与高收入相比,hs-CRP（OR=2.5,95%CI：1.1~6.3,p=0.04）高者更容易发生VCI。结论：牙齿缺失数多（≥8颗）是急性缺血性卒中后发生VCI的独立危险因素。Objective：To investigate the association of tooth loss with vascular cognitive impairment in patients with acute stroke.Method：190 subjects with acute ischemic stroke were recruited from the Yuebei People’ s Hospital affiliated to Medical College of Shantou University.After admission, the general conditions of patients and medical history were collected, and the medical fasting blood tests were undertaken within 24 hours.The number of teeth present was recorded within seven days.Cognitive impairment was evaluated with the Chinese version of Montreal Cognitive Assessment （ MoCA） within three days, as well as the severity of stroke evaluated with the National Institute of Health stroke scale （ NIHSS ） .Result：Univariate logistic re-gression analysis showed that age, education levels, income, stroke history and more teeth loss （ 8~28 vs 0~7） were significantly correlated with vascular cognitive impairment （ P〈0.01） .Body-mass index, diabe-tes, homocysteine and high-sensitivity C-reactive protein were marginally related with vascular cognitive im-pairment （ P〈0.1） .In the multiple Logistic regression analysis, loss ≥8 teeth （ OR=8.5, 95%CI：2.6~28.6, P=0.001） , low income （ OR=62.7, 95%CI：3.9~1018.1, P=0.007） with reference to high income and hs-CRP（ OR=2.5, 95%CI： 1.1~6.3, P=0.04） remained in the final model.Conclusion：Loss of multiple teeth（≥8） is one of the independent risk factors of vascular cognitive impairment in patients with acute stroke.

关 键 词：缺血性卒中 牙周病 牙齿缺失 血管性认知功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]