出血性脑梗死危险因素对记忆的影响  

Risk factors for hemorrhagic cerebral infarction and correlation with memory

作　　者：张丽杨[1] 刘凌[1] 张磊 

机构地区：[1]沈阳市第四人民医院神经内科,辽宁省沈阳市110004 [2]龙口市南山心血管病医院内科,山东省龙口市265701

出　　处：《中国临床康复》2004年第13期2430-2431,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析出血性脑梗死(hemorrhagicinfarction,HI)的危险因素,探讨其与学习记忆的关系,为脑卒中后记忆功能的康复提供帮助。方法:收集同期住院1650例急性脑梗死患者的临床资料,根据有无继发性脑出血分为HI组(48例)、非HI组(1602例),对两组患者的危险因素(年龄、性别、原发性高血压史、糖尿病病史、心房纤颤病史、梗死部位、梗死指数)进行统计学分析;并选择HI组配合检测的患者36例,采用《临床记忆量表》甲式进行测查,对测查结果进行统计学分析。结果:①HI的危险因素:HI与大面积脑梗死、梗死部位、心房纤颤病史及患者年龄相关(χ2分别为41.20,35.60,54.18,12.50,P<0.05)HI与患者性别、原发性高血压史、糖尿病病史无关(χ2分别为0.081.10,2.34,P>0.05)。②左侧脑梗死犤(73.12±11.88)分犦与右侧脑梗死犤(74.56±10.96)分犦记忆商(MQ)均明显下降,但两者无明显相关性(t=0.344,P>0.05);有糖尿病、原发性高血压者记忆障碍明显,MQ分别为(69.01±41.22),(71.05±16.15)分,与无糖尿者(90.03±16.01)分和无原发性高血压者(92.02±17.83)分比较,差异有非常显著性意义(t分别为4.11,3.70,P<0.001);而心脏病与记忆下降无明显相关性(t=0.11,P>0.05)。结论:对于大面积脑梗死、合并心房颤动疑为脑栓塞或皮质梗死患者应密?AIM:To assess the risk factors for hemorrhagic infarction(HI) and to investiga te the relation with learning and memory so as to help the rehabilitation of mem ory function following stroke. METHODS:Clinical data were collected from 1 650 patients with acute CI who wer e hospitalized in the same period.All the patients were allocated into HI group( n=48) and non-HI group(n=1 602) due to whether the patients had HI or not.Stati stical analysis of risk factors were performed.Clinical memory scale(chart A) wa s conducted in 36 patients selected from HI group,and the results were used for statistical analysis. RESULTS:①Risk factors for HI: HI was associated with large area of infarction , infarct site, history of auricular fibrillation and age(χ2=41.20,35.60,54.18, 12.50,P< 0.05),but not associated with gender,hypertensive history and diabetic history(χ2=0.08,1.10,2.34,P >0.05).②Memory quotients(MQ) of bilateral cerebral infarction were remarkably decreased to 73.12±11.88 in the left hemisphere and 74.56±10.96 in the right hemisphere,but there was no significant difference(t= 0.344,P >0.05).There were significant differences in the scores of MQ between th e hypertensive patients(71.05±16.15) and non-hypertensive patients(92.02±17.8 3),and between the diabetic patients(69.01±41.22) and non-diabetic patients(90 .03±16.01)(t=4.11, 3.70,P< 0.001). However, heart disease had no remarkable cor relation with hypomnesia(t=0.11,P >0.05). CONCLUSION:Patients with large area of infarction,cerebral embolism combined w ith auricular fibrillation or cortical cerebral infarction should be closely mon itored dynamically,as well as the possible occurrence of hemorrhage after cerebr al infarction.The patients should receive the re-examination of brain CT in tim e for directing clinical treatment.Attention should be paid to the appearance of memory disorder in patients with cortical infarction and multifocal infarction or combined with hypertension and diabetes mellitus.

关 键 词：出血性脑梗死 危险因素 病因 记忆障碍 并发症 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R338.64[医药卫生—临床医学]