卒中前痴呆的危险因素分析  

Risk factors for prestroke dementia

作　　者：杨洁[1] 区腾飞[2] 解龙昌[1] 殷建瑞[1] 蒲蜀湘[1] 郑扬波[1] 陈梦宇[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12期724-727,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的既往研究对卒中前痴呆(prestroke dementia,PSD)关注较少,特别是其危险因素的分析相对局限。有必要对卒中前痴呆的危险因素进行探讨。方法筛选2012年7月至2013年6月期间,连续住院的首次发病的缺血性卒中患者,在住院期间及出院1个月内,使用老年人认知功能下降知情者问卷(informant questionnaire on cognitive decline in the elderly,IQCODE)完成认知功能测定,其中IQCODE平均评分≥4分定义为PSD。结果共393例首次卒中患者入组。其中38例(9.1%)在卒中前3个月内有痴呆症状。Logistic回归分析结果显示:年龄(比数比OR=1.069,P=0.006),女性(OR=2.366,P=0.044)、顶叶萎缩(OR=2.624,P=0.049)及广泛脑萎缩(OR=3.623,P=0.009)是卒中前痴呆的独立危险因素。结论卒中前痴呆的危险因素包括年龄、女性、顶叶萎缩及广泛脑萎缩。应尽早对此进行识别并给予相应干预。应积极寻找顶叶萎缩和广泛脑萎缩的危险因素,以期对高危人群进行早期干预,减少卒中前痴呆的发生。Objetive Very few studies reported the risk factors for prestroke dementia（PSD）. In this study, we aimed to explore the risk factors for PSD in stroke patients among a Chinese hospital-based cohort.MethodsConsecutive stroke patients were recruited from two hospitals from July 2012 to June 2013. All the clinical features and risk factors were collected during hospitalization. The cognitive features of 393 patients were assessed by interviewing the caregivers using the Informant Questionnaire on Cognitive Decline in the Elderly（IQCODE） assessment.ResultsTotal 393 consecutive first-ever stroke patients completed their assessment. Among all patients, there were 38（9.1%） suffering from PSD. The independent risk factors for PSD were age（OR=1.069,P=0.006）, female gender（OR= 2.366, P=0.044）, parietal atrophy（OR=2.624,P=0.049） and global brain atrophy（OR=3.623,P=0.009）.ConclusionIt is necessary to evaluate the prestroke cognition among stroke patients. The risk factors for PSD include old age, female gender, parietal atrophy as well as global brain atrophy. In further study, we should make any effort to explore the risk factors for parietal atrophy and global brain atrophy in order to provide the ultimate intervention as early as possible and also prevent the occurrence of PSD.

关 键 词：卒中 卒中前痴呆 顶叶萎缩 广泛脑萎缩 

分 类 号：R749.13[医药卫生—神经病学与精神病学]