脑卒中患者智能状况及其与文化程度、基础疾病的相关性  

Correlation of intelligent status with culture level and elementary disease in p atients with stroke

作　　者：王蓓[1] 时恒屏[1] 李世滢[1] 

机构地区：[1]连云港市第一人民医院神经科,江苏省连云港市222002

出　　处：《中国临床康复》2003年第25期3486-3487,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨脑卒中患者智能状况及其影响因素,为减少和避免脑卒中患者智能障碍提供依据。方法:200例脑卒中患者犤男124例,女76例;平均年龄(66±10)岁犦均给予实验室检查及头颅CT扫描,测量病灶范围,计算病灶容积。病程1个月后进行神经功能缺损评分和简易精神状态检查法(MMSE)结合Hachinski缺血指数诊断血管性痴呆,应用汉密顿抑郁量表排除严重抑郁患者。比较痴呆组和非痴呆组患者临床资料、实验室和CT检查结果。结果:脑卒中后痴呆患者占36.5%(73/200)。痴呆组患者年龄犤(69±5)岁犦、神经功能缺损评分(27±10)分,高于非痴呆组(63±7)岁、(12±8)分(F=8.95,11.34,P<0.05)。痴呆组患者受教育≤6年者65.8%(48/73),非痴呆组仅为43.3%(55/127)(χ2=6.11,P<0.05)。痴呆组患者既往有高血压、糖尿病、脑卒中史者高于非痴呆组(87.7%,54.8%,38.4%比62.2%,26.8%,19.7%,χ2=6.15,9.47,9.95,P<0.05)。痴呆组患者血糖、三酰甘油、胆固醇和纤维蛋白原均高于非痴呆组(F=4.96～5.62,P<0.05)。CT显示痴呆组病灶多为多灶(63%比33.9%),病灶容积显著大于非痴呆组(χ2=6.46～7.07,P<0.05)。结论:脑卒中后痴呆是多种因素相互影响的结果,智能障碍与年龄大及神经功能缺损程度相关;与文化程度低和既往有高血压、糖尿病、脑卒中史相关;?AIM:To study the status and effect factors of intelligence in patients with st roke for the treatment of intelligence dysfunction. METHODS:Two hundred patients with stroke, including 124 males and 76 females w ith an average age of (66±10) years, received laboratory examination and skull CT scan, and all patients were selected without serious depression according to Hamilton depression rating scale. Neurologic impairment score, mini-mental stat e examination (MMSE) and Hachinski ischemia index were used to diagnose vascular dementia for the patients with the time of 1 month after stroke.The data were c ompared between the groups with dementia and without dementia. RESULTS:Dementia was found in 73 of the 200 patients with stroke (36.5 %).The patients with dementia were significantly higher in the average age [(69±5) ye ars] and MMSE score (27±10) than the patients without dementia [(63±7) years, (12±8)] (F=8.95,11.34,P< 0.05). The percentage of receiving education≤6 year s was 65.8%(48/73)for the patients with dementia and 43.3%(55/127)for the patients without dementia (,P< 0.05).The percentages of the patients with the history of hypertension, diabetes mellitus in the dementia group were 8 7.7%, 54.8%and 38.4%respectively, greatly higher than those of the group with out dementia (62.2%,26.8%and 19.7%respectively,,P< 0.0 5). The contents of blood sugar, triacylglycerol and cholesterol and fibrinogen were significantly higher in the group with dementia than in the group without d ementia (F=4.96-5.62,P< 0.05).CT scan showed that the percentage of focus was 63%in the dementia group, significantly higher than in the group without dement ia (33.9%), and focal size of the patients with dementia was bigger than that o f the patients without dementia (-7.07,P< 0.05).

关 键 词：脑卒中 智能状况 文化程度 基础疾病 

分 类 号：R743.3[医药卫生—神经病学与精神病学]