老年脑梗死患者认知障碍的相关危险因素研究  

The correlativestudy of cognitive impairment in elderly patients with cerebral infarction

作　　者：罗晓桐 于晶[1] 洪楠[1] 李莹[1] 

机构地区：[1]哈尔滨医科大学附属第一医院国际医学部,哈尔滨150000

出　　处：《国际精神病学杂志》2017年第1期64-67,71,共5页Journal Of International Psychiatry

摘　　要：目的分析老年脑梗死患者认知障碍发生的危险因素及甲钴胺的干预作用。方法选取2010年1月~2015年1月期间我院收治的310例脑梗死患者作为研究对象,比较认知障碍(CI)及未发生认知障碍(NCI)的临床资料,分析CI发生的危险因素;比较服用甲钴胺及未服用甲钴胺患者CI的发生率,分析甲钴胺的干预作用。结果 310例患者中,107例出现CI,发生率34.52%。年龄、受教育年限(≤6年)、糖尿病、左侧梗死、大面积梗死、脑白质疏松、白细胞介素-6(IL-6)及尿酸(UA)是CI发生的相关因素(P<0.05)。310例患者中,142例在住院期间应用甲钴胺,其中28例(19.72%)出现CI;未服用甲钴胺的患者的CI发生率为47.02%(79/168),差异具有统计学意义(χ~2=24.192,P<0.05)。校正年龄、糖尿病、左侧梗死、大面积梗死、脑白质疏松、IL-6及UA等干扰因素后,甲钴胺与CI的发生呈负相关,相关性具有显著意义(P<0.05)。结论老年脑梗死患者认知障碍的发生于多种因素有关,甲钴胺有改善患者认知功能的作用。Objective To analyze the risk factors of cognitive impairment in elderly patients with cerebral infarction and the intervention effect of mecobalamine. Methods 310 patients admitted in our hospital fi＇om January 2010 to Janumy 2015 were selected as study subjects. The risk factors of cognitive impairment were analyzed through the clinical data compari- son between the CI and NCI patients. We then compared the CI rates between patients treated with and without mecobalamine, and the intervention effect of mecobalamine was analyzed. Results 107 patients （ 34.52 % ） were diagnosed as cognitive impairment （ CI ） . Age, duration of education （ ≤ 6 years ）, diabetes, left hemisphere infarction, large area infarction, leukoarailosis, IL-6 and UA were found to be risk factors of cognitive impairment （ P 〈 0.05 ） . 28 patients （ 19.72 % ） who were given mecobalamine and 79 patients （47.02 % ） who were not were diagnosed as CI, and the difference was of statistical significance （ X 2=24.192, P〈0.05 ） . After adjustment for factors of age, duration of education, diabetes, left hemisphere infarction, large area infarction, leukoarailosis, IL-6 and uric acid （ UA ）, the use of mecobalamine was negatively cor- related with cerebral impairment （P 〈 0.05 ） . Conclusion The occurrence of cognitive impairment in elderly patients can be affected by multiple factors, and mecobalamine can help improve cognitive function in those patients.

关 键 词：脑梗死 认知障碍 甲钴胺 

分 类 号：R749[医药卫生—神经病学与精神病学]