中国卒中杂志 ›› 2017, Vol. 12 ›› Issue (09): 822-826.DOI: 10.3969/j.issn.1673-5765.2017.09.012

• 论著 • 上一篇    下一篇

急性缺血性卒中患者认知功能障碍影响因素分析

陈永明,吕薇,张建明,贾晓琳,孟霞   

  1. 1015100,巴彦淖尔内蒙古五原县人民医院
    2中国疾病预防控制中心
    3首都医科大学附属北京天坛医院神经病学中心
  • 收稿日期:2017-02-11 出版日期:2017-09-20 发布日期:2017-09-20
  • 通讯作者: 孟霞 mengxia45@163.com
  • 基金资助:

    北京市属医院科研培育计划项目(PX2016052)

Analysis of Influencing Factors of Cognitive Impairment in Patients with Acute Ischemic Stroke

  • Received:2017-02-11 Online:2017-09-20 Published:2017-09-20

摘要:

目的 探讨急性缺血性卒中患者认知功能障碍的影响因素。 方法 选取急性缺血性卒中患者氧化应激水平临床观察研究(Study on Oxidative Stress in Patients with Acute Ischemic Stroke,SOS-Stroke)的3285例患者作为研究对象,采用简易智力状态检查量表 (mini-mental state examination,MMSE)测定患者认知功能,急性缺血性卒中患者认知功能障碍的影响 因素采用多因素Logistic回归进行分析。 结果 该研究人群中有869例(26.45%)患有认知功能障碍,患者的年龄、性别、居住地、教育程度、 运动情况、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分对 急性缺血性卒中后认知功能障碍的影响有统计学意义。高脂血症[比值比(odds ratio,OR)1.38,95% 可信区间(confidence interval,CI)1.01~1.89,P =0.043] 、女性(OR 1.30,95%CI 1.04~1.63,P =0.020)、 NIHSS评分高(OR 1.26,95%CI 1.24~1.30,P <0.001)、居住于农村(OR 1.25,95%CI 1.02~1.53, P =0.026)及高龄(OR 1.03,95%CI 1.02~1.04,P <0.001)是急性缺血性卒中患者认知功能障碍的危 险因素,高教育水平(OR 0.77,95%CI 0.63~0.92,P =0.015)和经常运动(OR 0.80,95%CI 0.66~0.97, P =0.020)是其保护因素。 结论 应综合考虑急性缺血性卒中患者认知功能障碍的影响因素。

文章导读: 利用急性缺血性卒中患者氧化应激水平临床观察研究数据库分析急性缺血性卒中患者认知功能障碍的危险因素,结果显示高脂血症、性别、神经功能缺损、居住地、教育水平及运动情况都会影响卒中后患者的认知水平。

关键词: 急性缺血性卒中; 认知功能障碍; 影响因素

Abstract:

Objective To evaluate the influencing factors of cognitive impairment after acute ischemic stroke. Methods The study included 3285 patients who were subjects from the Study on Oxidative Stress in Patients with Acute Ischemic Stroke. The cognitive function of patients were determined by minimental state examination (MMSE), and the influence factors of cognitive impairment in patients with acute ischemic stroke were evaluated in multiple logistic regression analysis. Results The prevalence of cognitive impairment after acute ischemic stroke was 26.46% (n =869), and the difference between the groups in the aspect of patient's age, sex, place of residence, education, exercise, and National Institutes of Health Stroke Scale (NIHSS) score were statistically significant. Logistic regression analysis showed that the risk factors of cognitive impairment after acute ischemic stroke were hyperlipidemia [odds ratio (OR) 1.38, 95% confidence interval (CI) 1.01-1.89, P =0.043), women (OR 1.30, 95%CI 1.04-1.63, P =0.020), high National Institutes of Health Stroke Scale (NIHSS) score (OR 1.26, 95%CI 1.24-1.30, P <0.001), living in rural areas (OR 1.25, 95%CI 1.02- 1.53, P =0.026) and advanced age (OR 1.03, 95%CI 1.02-1.04, P <0.001). High education level (OR 0.77, 95%CI 0.63-0.92, P =0.015) and frequent exercise (OR 0.80, 95%CI 0.66-0.97, P =0.020) were

protective factors. Conclusion We should comprehensively take into account the influencing factors of cognitive impairment in patients with acute ischemic stroke.

Key words: Acute ischemic stroke; Cognitive impairment; Influencing factors