延安地区急性缺血性脑卒中患者认知障碍的危险因素分析  

Analysis of risk factors of cognitive impairment in patients with acute ischemic stroke in Yan'an area

作　　者：郝美美[1] 郑方 康志霞 王丽芬 HAO Meimei;ZHENG Fang;KANG Zhixia;WANG Lifen(Neurology Department,Yan'an People's Hospital,Yan'an 716000;No.1 Acupuncture and Moxibustion Department,Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003,China)

机构地区：[1]延安市人民医院神经内科,陕西延安716000 [2]陕西省中医医院针灸一科,陕西西安710003

出　　处：《临床医学研究与实践》2021年第28期40-42,56,共4页Clinical Research and Practice

基　　金：陕西省自然科学基础研究计划一般项目(No.2021JM-578)。

摘　　要：目的探究延安地区急性缺血性脑卒中患者认知障碍的发生情况及其危险因素。方法选取2017年2月至2019年6月我院收治的495例急性缺血性脑卒中患者作为研究对象,对其进行蒙特利尔认知评估量表(MoCA)评分,将MoCA评分<26分者纳入认知障碍组,MoCA评分≥26分者纳入非认知障碍组。采集两组患者的人口学资料、一般临床资料、实验室及超声影像学资料,并进行比较分析。结果急性缺血性脑卒中患者495例中,认知障碍者258例(52.12%),非认知障碍者237例(47.88%)。两组的文化程度、吸烟、脑卒中史、高血压、NIHSS评分、同型半胱氨酸、颈动脉硬化斑块形成情况比较,差异具有统计学意义(P<0.05)。非条件Logistic回归分析结果显示,文化程度、吸烟、脑卒中史、高血压、NIHSS评分、同型半胱氨酸及颈动脉硬化斑块形成为急性缺血性脑卒中后认知障碍的危险因素(P<0.05)。结论延安地区急性缺血性脑卒中患者认知障碍发生率较高。文化程度低、吸烟、既往有脑卒中病史、高血压、NIHSS评分高、高同型半胱氨酸水平及颈动脉硬化斑块形成的急性缺血性脑卒中患者更容易发生认知障碍,临床应密切关注上述危险因素,并及时给予合理干预。Objective To explore the incidence and risk factors of cognitive impairment in patients with acute ischemic stroke in Yan'an area.Methods A total of 495 patients with acute ischemic stroke admitted in our hospital from February 2017 to June 2019 were selected as the research objects,and scored with the montreal cognitive assessment scale(MoCA).Those with MoCA score<26 were included in cognitive impairment group,and those with MoCA score≥26 were included in non-cognitive impairment group.The demographic data,general clinical data,laboratory and ultrasonic imaging data of the two groups were collected,compared and analyzed.Results Among the 495 patients with acute ischemic stroke,there were 258 patients with cognitive impairment(52.12%)and 237 patients with non-cognitive impairment(47.88%).There were significant differences in educational level,smoking,stroke history,hypertension,NIHSS score,homocysteine and carotid atherosclerotic plaque formation between the two groups(P<0.05).The results of unconditional Logistic regression analysis showed that educational level,smoking,stroke history,hypertension,NIHSS score,homocysteine and carotid atherosclerotic plaque were the risk factors of cognitive impairment after acute ischemic stroke(P<0.05).Conclusion The incidence of cognitive impairment in patients with acute ischemic stroke is high in Yan'an area.Acute ischemic stroke patients with low educational level,smoking,previous stroke history,hypertension,high NIHSS score,high homocysteine level and carotid atherosclerotic plaque may be more prone to cognitive impairment.Clinically,above risk factors should be paid close attention,and reasonable intervention shoud be given in time.

关 键 词：急性缺血性脑卒中 认知障碍 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]