急性缺血性脑卒中患者90天后发生认知功能障碍的多因素分析  

Multivariate analysis of cognitive dysfunction in patients with acute ischemic stroke 90 days later

作　　者：潘晓帆[1] 秦琳[1] 韩杨[1] 朱晓华 周燕[1] 姜亦伦 董万利[3] 郭强[4] Pan Xiaofan;Qin Lin;Han Yang;Zhu Xiaohua;Zhou Yan;Jiang Yilun;Dong Wanli;Guo Qiang(Neurology Department,Wuxi Branch of Zhongda Hospital,Southeast University,Wuxi 214105,China;Department of Medical Imaging,Wuxi Branch of Zhongda Hospital,Southeast University,Wuxi 214105y China;Neurology Department,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;ICU,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]东南大学附属中大医院无锡分院神经内科,214105 [2]东南大学附属中大医院无锡分院影像科,214105 [3]苏州大学附属第一医院神经内科,215006 [4]苏州大学附属第一医院重症医学科,215006

出　　处：《神经疾病与精神卫生》2019年第1期7-11,共5页Journal of Neuroscience and Mental Health

基　　金：国家自然科学基金青年项目(81300040);无锡市卫生计生委科研项目(MS201640).

摘　　要：目的探究急性缺血性脑卒中(AIS)后发生认知功能障碍的主要影响因素。方法选取2015年1月一2018年1月东南大学附属中大医院无锡分院收治的160例AIS患者,患者随访90d,对所有患者进行认知功能评估,采用Logistic回归分析AIS病情、血管危险因素、血清生化指标、病变部位等临床资料对认知功能障碍发生的影响。结果本研究160例AIS患者90d后发生认知功能障碍的占35.0%(56/160)。患者年龄增加、受教育程度﹤12年、酗酒史、贫血、运动功能障碍等均导致认知功能障碍发生率升高(P﹤0.05)。单因素结果显示,受教育程度、饮酒、年龄、运动障碍、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hey)水平及枕叶(左)、颞叶(左)、背侧丘脑、后丘脑、额叶(左)病变部位与AIS患者确诊90d后认知功能障碍的发生有关。多因素回归分析显示,患者受教育程度、年龄、饮酒、运动障碍、hSCRP、Hey、枕叶(左)、背侧丘脑、额叶(左)为AIS患者90d后发生认知功能障碍的危险因素。结论了解AIS患者基本资料、病变部位、同型半胱氨酸及hS-CKP水平等,并采取相应措施,对于降低认知功能障碍的发生有重要意义。Objective To investigate the main influencing factors of cognitive dysfunction(CD)after acute ischemic stroke(AIS).Methods A total of 160 patients with AIS in Wuxi Branch of Zhongda Hospital Affiliated to Southeast University from January 2015 to January 2018 were selected.The patients were followed up for 90 days.The cognitive function of all patients was evaluated.Logistic regression analysis were applied to analyze the effects of AIS condition,vascular risk factors,serum biochemical indicators,lesion location and other clinical data on the occurrence of CD.Results In this study,35.0%(56/160)of 160 AIS patients developed cognitive impairment 90 days later.Increased age,less than 12 years of education,history of alcohol abuse,anemia and dyskinesia all lead to increased incidence of cognitive dysfunction(P﹤0.05).Univariate analysis showed that the level of education,alcohol consumption,age,dyskinesia,hypersensitive C-reactive protein(hs-CRP),homocysteine(Hey),occipital lobe(left),temporal lobe(left),dorsal thalamus,posterior thalamus and frontal lobe(left)were associated with the occurrence of CD in AIS patients 90 days after diagnosis.Multivariate regression analysis showed that education level,age alcohol consumption,dyskinesia,hs-CRP,Hey,occipital lobe(left),dorsal thalamus and frontal lobe(left)were the risk factors for CD in AIS patients 90 days after diagnosis.Conclusions Understanding the basic information of AIS patients,the location of the lesion and the level of Hey and hs-CRP in the body,and taking corresponding measures are of great significance to reduce the occurrence of cognitive impairment.

关 键 词：卒中 认知功能障碍 同型半胱氨酸 超敏C反应蛋白 病变部位 

分 类 号：R749.16[医药卫生—神经病学与精神病学]