老年高血压脑卒中患者认知障碍的危险因素分析  

Analysis of risk factors of cognitive dysfunction in elderly patients with hypertensive stroke

作　　者：苟梦琪 孙海清 杨源瑞 左冠超[2] Gou Mengqi;Sun Haiqing;Yang Yuanrui;Zuo Guanchao(Second Ward of First Department of Cadre Ward,General Hospital of Western Theater Command,Chengdu,Sichuan,610083,P.R.China;Department of Integrated Traditional Chinese and Western Medicine,Rehabilitation Hospital of Sichuan Province(Sichuan Bayi Rehabilitation Center)Affiliated to Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan,610000,P.R.China)

机构地区：[1]西部战区总医院干一科二病区,四川成都610083 [2]成都中医药大学附属四川省康复医院(四川省八一康复中心)中西医结合科,四川成都610000

出　　处：《老年医学与保健》2021年第5期982-986,共5页Geriatrics & Health Care

基　　金：四川省中医药管理局科学技术研究项目(2018LC013)。

摘　　要：目的分析老年高血压脑卒中患者出现认知障碍(post-stroke cognitive dysfunction,PSCD)的危险因素。方法收集于2017年6月-2020年6月期间在西部战区总医院神经内科接受治疗的125例高血压脑卒中患者的临床资料,根据是否出现PSCD分为PSCD组和非PSCD组,比较2组患者一般资料和高血压脑卒中合并PSCD的危险因素等。结果单因素差异分析显示,年龄、文化水平、脑血管狭窄程度、梗死体积、脑萎缩、高血压分级、糖尿病、冠心病与尿失禁等因素具有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄、脑血管狭窄程度、高血压Ⅲ级是高血压脑卒中患者PSCD主要影响因素,文化水平为高血压脑卒中患者PSCD保护因素;Logistic回归模型预测老年高血压脑卒中患者PSCD的曲线下面积值AUC为0.931 (95% CI:0.872~0.969),约登指数为0.792,以0.816为临界值,其预测老年高血压脑卒中患者PSCD的敏感度、特异度分别为91.94%、87.30%。结论年龄、文化程度、脑血管狭窄程度、高血压Ⅲ级与高血压脑卒中患者PSCD密切相关,基于上述因素构建的Logistic回归模型预测高血压脑卒中患者PSCD具可靠效能。Objective To analyze the risk factors of post-stroke cognitive dysfunction(PSCD)in elderly patientswith hypertensive stroke.Methods The clinical data of 125 patients with hypertensive stroke treated in the Department of Neurology of General Hospital of Western Logistic regressio June 2017 to June 2020 were collected.The patients were divided into PSCD group and non-PSCD groupaccording to the presence or absence of PSCD.The general data were compared between the two groups to screen the risk factors of hypertensive stroke complicated with PSCD.Results Univariate analysis showed that there were significant differences in age,education level,cerebral vascular stenosis,infarct volume,cerebral atrophy,hypertension grade,diabetes,coronary heart disease and urinary incontinence between the two groups(P<0.05).Multivariate Logistic regression analysis showed that age,degree of cerebrovascular stenosis and gradeⅢhypertension were the main influencing factors of PSCD in patients with hypertensive stroke,and education level was a protective factor of PSCD.The area under the curve(AUC)of logisticsregression model to predict PSCD in elderly patients with hypertensive stroke was 0.931(95%CI:0.872-0.969),and the Youden index was 0.792.Taking 0.816 as the cut-off value,the sensitivity and specificity of predicting PSCD in elderly patients with hypertensive stroke were 91.94%and 87.30%,respectively.Conclusion Age,edu-cation level,degree of cerebrovascular stenosis,and hypertension gradeⅢare closely related to PSCD in patients with hy-pertensive stroke.The Logistics regression model constructed based on the above factors is reliable in predicting PSCD in pa-tients with hypertensive stroke.

关 键 词：老年 高血压 脑卒中 认知障碍 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]