急性缺血性脑卒中患者认知障碍的危险因素分析  

Risk factors of cognitive impairment in patients with acute ischemic stroke

作　　者：王丽君 袁绘 李凡凡 张萍[1] 李娟 杨鹏飞[1] 张永巍[1] 刘建民[1] WANG Lijun;YUAN Hui;LI Fanfan;ZHANG Ping;LI Juan;YANG Pengfei;ZHANG Yongwei;LIU Jianmin(Neurovascular Center,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China;Department of Clinical Nursing,School of Nursing,Naval Medical University(Second Military Medical University),Shanghai 200433,China;Department of Nursing,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]海军军医大学(第二军医大学)第一附属医院脑血管病中心,上海200433 [2]海军军医大学(第二军医大学)护理系临床护理学教研室,上海200433 [3]复旦大学附属华山医院护理部,上海200040

出　　处：《海军军医大学学报》2023年第8期904-910,共7页Academic Journal of Naval Medical University

基　　金：中华国际医学交流基金会脑血管病青年创新基金(Z-2016-20-2201)。

摘　　要：目的探讨急性缺血性脑卒中(AIS)患者发生认知障碍的危险因素。方法选择2022年8月至12月海军军医大学(第二军医大学)第一附属医院脑血管病中心收治的AIS患者100例作为研究对象,根据简易智能精神状态检查量表(MMSE)评分分为认知功能正常组(59例)和认知障碍组(41例)。采集并比较两组患者的基本临床资料、实验室检查结果、影像学检查结果及蒙特利尔认知评估量表(MoCA)、9条目患者健康问卷抑郁量表(PHQ-9)、Lubben社会网络量表(LSNS-6)、加利福尼亚大学洛杉矶分校孤独量表第3版(UCLA-3)评估资料。采用二元logistic回归模型分析AIS患者发生认知障碍的危险因素。结果与认知功能正常组相比,认知障碍组患者年龄较大(P=0.012),受教育年限较低(P=0.045),有糖尿病病史的患者比例较高(P=0.026),MMSE评分(P<0.001)、MoCA评分(P<0.001)和LSNS-6评分(P=0.012)较低,PHQ-9评分(P<0.001)和UCLA-3评分较高(P=0.002)。两组患者的牛津郡社区卒中规划(OCSP)临床表现分型(P=0.031)差异有统计学意义。二元logistic回归分析结果显示,年龄(OR=1.070,95%CI 1.020~1.123,P=0.005)和完全前循环梗死(OR=55.633,95%CI 2.041~1516.526,P=0.017)是AIS患者发生认知障碍的危险因素。结论年龄和完全前循环梗死是AIS患者发生认知障碍的危险因素。Objective To investigate the risk factors of cognitive impairment in patients with acute ischemic stroke(AIS).Methods A total of 100 AIS patients in Neurovascular Center,The First Affiliated Hospital of Naval Medical University(Second Military Medical University)from Aug.to Dec.2022 were enrolled.According to the mini mental status evaluation(MMSE)score,the patients were divided into normal cognitive group(59 cases)and impaired cognitive group(41 cases).The basic clinical data,laboratory and imaging examination data,Montreal cognitive assessment(MoCA),patient health questionnaire-9(PHQ-9),Lubben social network scale(LSNS-6)and University of California,Los Angeles loneliness scale-version 3(UCLA-3)of the patients in the 2 groups were collected.Binary logistic regression model was used to analyze the risk factors of cognitive impairment in AIS patients.Results Compared with the normal cognitive group,the impaired cognitive group was older(P=0.012),had lower level of education(P=0.045),higher proportion of diabetes mellitus history(P=0.026),and lower MMSE score(P<0.001),MoCA score(P<0.001)and LSNS-6 score(P=0.012),and higher PHQ-9 score(P<0.001)and UCLA-3 score(P=0.002).Moreover,there was significant difference in Oxfordshire Community Stroke Project(OCSP)classification(P=0.031)between the 2 groups.Binary logistic regression analysis showed that age(odds ratio[OR]=1.070,95%confidence interval[CI]1.020-1.123,P=0.005)and total anterior circulation infarct(OR=55.633,95%CI 2.041-1516.526,P=0.017)were risk factors for cognitive impairment in AIS patients.Conclusion Age and total anterior circulation infarct are risk factors of cognitive impairment in AIS patients.

关 键 词：急性缺血性脑卒中 认知障碍 危险因素 年龄 完全前循环梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]