脑梗死急性期淡漠预测因素的研究  

Predictors of Apathy in Acute Stage of Cerebral Infarction

作　　者：王君[1,2] 于治华[2] 王正则[2] 高连波[2] 曹云鹏[1] 

机构地区：[1]中国医科大学附属第一医院神经内科,辽宁沈阳市110001 [2]中国医科大学附属第四医院神经内科,辽宁沈阳市110032

出　　处：《中国康复理论与实践》2015年第8期934-938,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家自然科学基金项目(No.81371227)

摘　　要：目的探讨脑梗死急性期淡漠与梗死部位、血浆同型半胱氨酸(Hcy)是否相关,分析卒中后淡漠可能的预测因素。方法急性脑梗死患者152例作为病例组,体检者152名作为对照组。应用淡漠量表评估卒中后淡漠,美国国立卫生研究院卒中量表(NIHSS)评价神经功能缺损,头磁共振弥散加权成像(DWI)检查评估梗死部位,改良Fazekas量表评价脑白质疏松程度,抽静脉血检测Hcy。结果病例组淡漠发病率显著高于对照组(P<0.001)。多因素Logistic分析中显示,额叶病变(P=0.013)、基底节病变(P=0.004)、脑桥病变(P<0.001)、较高Hcy水平(P<0.001)是卒中后淡漠的危险因素。结论额叶病变、基底节病变、脑桥病变、较高Hcy水平可能是卒中后淡漠的预测因素。Objective To explore the relationship between apathy and lesion location and serum homocysteine during the acute stage of ischemic stroke.Methods 152 patients with acute cerebral infarction were recruited.152 volunteers from medical center were as control group.The Apathy Scale（AS） was used to assess poststroke apathy（PSA）.National Institutes of Health Stroke Scale（NIHSS） was used to assess the severity of stroke.Magnetic resonance imaging（MRI） with diffusion-weighted imaging（DWI） was used to evaluate the lesion location.Modified Fazekas Scale was used to assess leukoaraiosis.The serum levels of homocysteine of patients were determined.Results The prevalence of PSA was significantly higher in the patients than in the control group（P〈0.001）.Multivariate logistic regression demonstrated that frontal lesion（P=0.001）,basal ganglia lesion（P=0.006）,pons lesion（P=0.002） and higher homocysteine level（P〈0.001） significantly related with PSA.Conclusion Frontal lesion,basal ganglia lesion,pons lesion and higher homocysteine level may be predictors for apathy in acute stage of ischemic stroke.

关 键 词：脑卒中 淡漠 梗死部位 同型半胱氨酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]