缺血性脑血管病认知功能障碍的危险因素分析  

Analysis on risk factors of vascular cognitive impairment with ischemic cerebrovascular disease

作　　者：李春芳 张干[1] LI Chun-fang;ZHANG Gan(Department of Neurology, The Third People's Hospital of Bengbu, Anhui 233000, China)

机构地区：[1]安徽省蚌埠市第三人民医院神经内科

出　　处：《淮海医药》2019年第4期359-363,共5页Journal of Huaihai Medicine

摘　　要：目的:探讨缺血性脑血管病认知功能障碍的危险因素。方法:收集缺血性脑卒中或有缺血性脑卒中危险因素的患者511例。根据MMSE、MoCA评分及ADL评分,并结合CDR量表得出相应的CDR分值进行分组,即无认知障碍组(认知正常组),非痴呆性血管性认知功能障碍组(VCIND组)及血管性痴呆组(VD组)。对患者的一般情况、血管性危险因素、年龄、受教育年限及急性卒中患者NHISS评分等资料进行采集分析。结果:VCI组(包括VCIND组和VD组)与认知功能正常组比较,糖尿病、冠心病、房颤、高胆固醇血症及既往卒中病史的比例均较高,Logistic回归分析提示对血管性认知功能障碍的发生有影响的变量为高龄、低受教育年限、糖尿病、高同型半胱氨酸血症的发生(P<0.05)。急性脑卒中患者VD组平均NHISS评分高于认知功能正常组及VCIND组。结论:高龄、糖尿病及高同型半胱氨酸血症及低受教育水平是影响缺血性脑血管病发生认知功能障碍的主要危险因素。存在严重的神经功能缺损的急性脑卒中患者更易出现血管性痴呆。Objective: To explore the risk factors of vascular cognitive impairment (VCI) in ischemic cerebrovascular disease patients. Methods: 511 cases with acute ischemic stroke or with risk factors of ischemic cerebrovascular disease were collected and were divided into 3 groups: non-VCI group, VCIND (vascular cognitive impairment with no dementia) group and VD (vascular dementia ) group.Basic data such as vascular risk factors, age, education degree and NIHSS scores of the patients were collected and analyzed. Results: The rate of diabetes mellitus, coronary artery disease, atrial fibrillation, hypercholesterolemia, and history of stroke in the VCI group was significantly higher compared to the normal group ( P <0.05). Logistic regression analysis indicated that age, schooling years, diabetes mellitus and hyperhomocysteinemia were related to the development of VCI ( P <0.05). Conclusion: Older age, diabetes mellitus, hyperhomocysteinemia and fewer schooling years are main risk factors for the development of VCI in ischemic cerebrovascular disease patients. Acute ischemic stroke patients with severe neurological deficits are more likely to develop vascular dementia.

关 键 词：缺血性脑血管病 认知功能障碍 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]