脑卒中后认知障碍患者蒙特利尔认知评估量表变化特征及其与TOAST亚型的关系  

Relationship between characteristics of MoCA and subtypes of TOAST in patients with post-stroke cognitive impairment

作　　者：刘娜[1] 孟品 耿闪 籍牛[1] 孙永安[1] 徐英达[1] 何明利[1] 

机构地区：[1]徐州医学院附属连云港医院神经内科,222000

出　　处：《中华老年心脑血管病杂志》2016年第4期345-348,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：江苏省科技厅临床医学科技项目(BL2014062);江苏省卫生厅科研基金(H2014061)

摘　　要：目的探讨脑卒中后认知障碍（PSCI）患者蒙特利尔认知评估量表（MoCA）亚因子变化特征及其与TOAST亚型的关系。方法选取发病24h内住院的首发急性缺血性脑卒中患者708例,根据TOAST分型分为大动脉粥样硬化型（LA）组256例、小动脉闭塞型（SA）组110例、心源性栓塞型组212例、其他原因所致的缺血性脑卒中组34例、不明原因的缺血性脑卒中组96例,对比分析患者入院时,发病14d,3、6、12个月的MoCA分值变化特征,采用多参数对数回归分析MoCA亚因子与TOAST分型的关系。结果与发病14d时比较,PSCI患者发病3个月时视空间和执行能力、延迟记忆、注意能力显著降低[（1.59±1.30）分vs（2.44±1.18）分,（1.94±1.47）分vs（2.81±1.47）分,（3.06±1.34）分vs（4.28±1.66）分,P〈0.05]。以SA组为参照,发病3个月时PSCI患者的发病风险以LA组最高（OR=1.326,95%CI：0.995~1.658,P=0.031）。结论 PSCI患者的视空间和执行能力、延迟记忆和注意能力均显著下降,尤其是LA组患者。Objective To study the relationship between characteristics of MoCA and subtypes of TOAST in patients with post-stroke cognitive impairment（PSCI）.Methods Seven hundred and eight patients with first onset of acute ischemic stroke（AIS）were divided into large artery（LA）sclerosis group（n=256）,small artery（SA）occlusion group（n=110）,cardiogenic embolism group（n=212）,ischemic stroke group（n=34）and idiopathic ischemic stroke group（n=96）.Their MoCA scores on admission,on day 14 and 3,6,12 months after onset of the disease were comparatively analyzed.The relationship between characteristics of MoCA and subtypes of TOAST was analyzed by multivariate logistic regression analysis.Results The MoCA scores of visual space and execution,delayed memory and attention were significantly lower in PSCI patients 3months after onset of the disease than on day 14 after onset of the disease（1.59±1.30 vs2.44±1.18,1.94±1.47 vs 2.81±1.47,3.06±1.34 vs 4.28±1.66,P〈0.05）.The risk for occurrence of the disease was significantly higher in LA sclerosis group than in SA occlusion group（OR=1.326,95%CI=0.995-1.658,P=0.031）3months after onset of the disease.Conclusion The MoCA scores of visual space and execution,delayed memory and attention were significantly lower in PSCI patients,especially in those with LA sclerosis.

关 键 词：卒中 认知障碍 动脉粥样硬化 记忆障碍 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]