急性脑梗死后认知障碍相关因素的分析  

FACTORS RELATED TO COGNITIVE IMPAIRMENT IN ACUTE CEREBRAL INFARCTION

作　　者：尹立勇[1] 尹博文[1] 杨昊翔[1] 甄蕊[1] 李军良[2] 董晓娇[1] YIN Liyong;YIN Bowen;YANG Haoxiang;ZHEN Rui;LI Junliang;DONG Xiaojiao(Department of Neurology,The First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院神经内科,066000 [2]秦皇岛市第一医院检验科

出　　处：《中国煤炭工业医学杂志》2022年第3期271-275,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省高层次人才资助项目(编号A202002026)。

摘　　要：目的 分析与急性脑梗死后认知障碍有关的多种因素,评估其预测价值。方法 将2020年1月—2021年1月入住秦皇岛市第一医院神经内科的急性脑梗死患者采用MoCA量表进行分类,将卒中后认知障碍(PSCI)组作为观察组,无认知障碍(NCI)组作为对照组,采集二组患者的临床数据,先进行单因素比较,再采用多变量Logistic分析二组患者差异有统计学意义的指标。结果 收集了283例急性脑梗死患者,PSCI组134例(47.3%),NCI组149例(52.7%)。二组患者的年龄、既往有脑卒中病史、NIHSS评分、脑梗死面积大小、脑梗死数量、脑白质稀疏程度、D-二聚体差异均有统计学意义(均P<0.05),多变量Logistic分析显示年龄、既往有脑卒中史、脑白质稀疏程度、脑梗死面积是卒中后认知障碍的独立危险因素。结论 急性脑梗死患者PSCI的发生比例较高;急性脑梗死患者中年龄大、既往有卒中史、脑梗死面积大、脑白质稀疏程度重的易发生PSCI,可针对这些因素早期进行PSCI的风险预测。Objective The present study aimed to investigate the factors associated with cognitive impairment after acute stroke and to assess their predictive value.Methods The acute cerebral infarction patients who were admitted to the Department of Neurology of Qinhuangdao First Hospital from January 2020 to January 2021 were classified by MoCA scale.PSCI group was used as observation group and NCI group was used as control group.Their clinical datas were collected and analyzed during the two groups.Firstly we performed the datas by univariate comparison.Finally,we used multivariate logistic regression analysis to analyze the datas which have significant differences.Results To collect two hundred and eighty-three acute stroke patients,134 cases(47.3%) in the PSCI group and 149 cases(52.7%) in the NCI group.The results of univariate comparison indicated that there were highly statistically significant differences in age,stroke history,NIHSS score,infarction area,number of cerebral infarction,cerebral white matter rarefaction and D-Dimer(P<0.05).The results of multivariate logistic regression model revealed that the age,stroke history,stroke area and cerebral white matter rarefaction were positively correlated with the occurrence of PSCI.Conclusion The incidence of PSCI was higher in patients with acute cerebral infarction.Patients with acute cerebral infarction who are older,have stroke history,have large cerebral infarction area and have severe white matter sparsity are prone to PSCI,and that can predict the risk of PSCI in early stage.

关 键 词：急性脑梗死 认知障碍 相关因素 

分 类 号：R741[医药卫生—神经病学与精神病学]