脑梗死后血管性认知功能损害与rt-PA 静脉溶栓的相关性  

Relationship between vascular cognitive impairment after cerebral infarction and intravenous thrombolysis by rt-PA

作　　者：朱衡亚[1] 孙晓燕[1] 胡正刚[1] 罗小春[2] 王庄[1] 冯琪 ZHU Heng-ya;SUN Xiao-yan;HU Zheng-gang;LUO Xiao-chun;WANG Zhuang;FENG Qi(Department of Neurology,Huzhou Central Hospital Affiliated Central Hospital Huzhou University,Huzhou,Zhejiang 313003,China;不详)

机构地区：[1]湖州市中心医院(湖州师范学院附属中心医院)神经内科,浙江湖州313003 [2]中国人民解放军陆军第七十二集团军医院神经内科,浙江湖州313000 [3]杭州市第一人民医院神经内科,浙江杭州310000

出　　处：《中华全科医学》2020年第6期962-964,共3页Chinese Journal of General Practice

基　　金：浙江省医学会临床科研基金项目(2016ZYC-A67);浙江省医药卫生科技计划创新人才支持项目(2020RC092)。

摘　　要：目的探讨脑梗死后血管性认知功能损害与rt-PA静脉溶栓的相关性,为临床提供参考。方法选取2016年1月-2018年2月湖州市中心医院收治的脑梗死患者46例作为研究对象,所有患者均给予rt-PA静脉溶栓治疗,患者入院后均完成MMSE、NIHSS、MoCA评分,根据评估结果分为认知功能障碍组、认知功能正常组。查阅2组病例资料,记录2组年龄、关键部位梗死、教育程度、血糖控制不佳、rt-PA静脉溶栓、高血压史、嗜酒、左侧梗死资料,并完成单因素及多因素logistic分析,针对患者认知功能危险因素制定有效的措施进行干预。结果 46例脑梗死患者29例发生血管性认知功能损害,占63.04%。单因素结果表明:脑梗死后血管性认知功能损害发生与年龄(t=2.244,P=0.030)、关键部位梗死(χ^2=4.313,P=0.038)、教育程度(U=8.092,P=0.003)、rt-PA静脉溶栓(χ^2=7.558,P=0.006)具有相关性(P<0.05);多因素logistic分析结果表明:年龄(P=0.042)、关键部位梗死(P=0.025)、教育程度(P=0.041)、rt-PA静脉溶栓(P=0.030)是脑梗死后血管性认知功能损害发生的影响因素(P<0.05)。结论脑梗死后血管性认知功能损害发生率较高,受到的影响因素较多,尽早给予患者rt-PA静脉溶栓治疗有助于改善患者认知功能,减轻患者病情。Objective To investigate the relationship between vascular cognitive impairment and rt-PA intravenous thrombolysis after cerebral infarction. Methods Forty-six patients with cerebral infarction treated from January 2016 to February 2018 were enrolled. All patients were treated with rt-PA intravenous thrombolysis. The patients were completed with MMSE, NIHSS and MoCA scores after admission. They were divided into cognitive dysfunction group and a cognitive function normal group. The data of the two groups were reviewed. The age, infarction, education level, poor glycemic control, rt-PA intravenous thrombolysis, history of hypertension, alcoholism, left infarction, and single factor and multivariate logistic were recorded. The effective measures for the patient’s cognitive function risk factors were analyzed, established and intervened. Results In 46 patients with cerebral infarction, 29(63.04%) had vascular cognitive impairment. The results of single factor analysis showed that the incidence and age of vascular cognitive impairment after cerebral infarction(t=2.244, P=0.030), infarction in key position(χ^2=4.313, P=0.038), education level(U=8.092, P=0.003), rt-PA intravenous thrombolysis(χ^2=7.558, P=0.006) were statistically significant(all P<0.05). The results of multi factor logistic analysis showed that the incidence of vascular cognitive impairment after cerebral infarction was statistically significant(P<0.05). There were significant differences in the birth rate and age(P=0.042), critical site infarction(P=0.025), education level(P=0.041), rt-PA intravenous thrombolysis(P=0.030). Conclusion The incidence of vascular cognitive impairment after cerebral infarction is high, and there are many influencing factors. Early administration of rt-PA intravenous thrombolytic therapy can improve the cognitive function and reduce the patient’s condition.

关 键 词：脑梗死 血管性认知功能损害 RT-PA静脉溶栓 相关性 基线因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]