脑梗死急性期低白蛋白血症与卒中后认知障碍相关性研究  

Hypoalbuminemia in acute ischemic stroke is associated with post-stroke cognitive impairment at 6 months

作　　者：李淑恩[1] 郑伟城[1] 林显仙[1] 方学文[1] 潘一杏 符小丽[1] 石铸[1] LI Shuen;ZHENG Weicheng;LIN Xianxian;FANG Xuewen;PAN Yixing;FU Xiaoli;SHI Zhu(Dongguan People’s Hospital,Dongguan 523059,China)

机构地区：[1]东莞市人民医院神经内科

出　　处：《中国神经精神疾病杂志》2020年第2期75-79,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：东莞市科技计划项目(编号:201750715001272);广东省护理学会科研项目(编号:gdhlxueh2019zx220)。

摘　　要：目的探讨脑梗死患者急性期血清低白蛋白血症与卒中6个月后认知障碍的相关性。方法采用回顾性队列研究方法连续登记急性脑梗死患者,收集人口学、临床、实验室以及影像学资料,随访至出院6个月并完善MMSE量表检查;按照卒中后6个月内有无认知障碍(post-stroke cognitive impairment,PSCI)分组,建立logistic回归模型分析急性期低蛋白血症与卒中后认知障碍的关系。结果408例入组患者中57例(14.0%)合并低白蛋白血症,6个月随访时124例(30.4%)出现PSCI。PSCI组患者血清白蛋白均值水平显著低于非PSCI组[(35.3±4.6)g/L vs.(38.6±3.5)g/L,P=0.033],且低白蛋白血症患者比例显著高于非PSCI组(20.2%vs.11.2%,P=0.017)。校正年龄,高血压,基线NIHSS和Fazekas评分等因素后,血清低白蛋白血症与PSCI显著相关(OR=1.989,95%CI:1.122~3.525,P=0.019)。结论脑梗死急性期低白蛋白血症是PSCI的危险因素,及时纠正可能有助于减少PSCI风险。Objective To explore the relationship between hypoalbuminemia in acute ischemic stroke and post-stroke cognitive impairment 6 months after stroke.Method This was a retrospective cohort study.Patients with acute ischemic stroke were consecutively registered.Demographic,risk factors,laboratory and radiological data were collected using standardized tables.Patients were followed up 6 months later and MMSE were used for cognitive assessment.Patients were grouped based on the occurrence of PSCI and factors contributing to PSCI were further investigated by multivariate logistic regression model.Results Of 408 eligible patients,hypoalbuminemia was found in 57 cases(14.0%).One huandard twenty-four patients(30.4%)were diagnosed as PSCI at 6-month follow-up.Compared to patients without PSCI,PSCI patients had significantly lower mean serum albumin level[(35.3±4.6)g/L vs.(38.6±3.5)g/L,P=0.033]and higher percentage of hypoalbuminemia(20.2%vs.11.2%,P=0.017).After multivariate adjustment,hypoalbuminemia was associated with higher risk of PSCI(OR=1.989,95%CI:1.122~3.525,P=0.019).Conclusion Hypoalbuminemia in acute ischemic stroke is a significant risk factor for PSCI and proper nutritional intervention may reduce the risk of PSCI.

关 键 词：低白蛋白血症 危险因素 脑卒中 卒中后认知障碍 

分 类 号：R743[医药卫生—神经病学与精神病学]