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急性缺血性脑卒中患者90 天后发生认知 功能障碍的多因素分析
潘晓帆秦琳韩杨朱晓华周燕姜亦伦董万利郭强
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摘要:
目的 探究急性缺血性脑卒中(AIS)后发生认知功能障碍的主要影响因素。方法 选取 2015 年1 月—2018 年1 月东南大学附属中大医院无锡分院收治的160 例AIS 患者,患者随访90 d,对所 有患者进行认知功能评估,采用Logistic 回归分析AIS 病情、血管危险因素、血清生化指标、病变部位 等临床资料对认知功能障碍发生的影响。结果 本研究160 例AIS 患者90 d 后发生认知功能障碍的占 35.0%(56/160)。患者年龄增加、受教育程度< 12 年、酗酒史、贫血、运动功能障碍等均导致认知功能障 碍发生率升高(P<0.05)。单因素结果显示,受教育程度、饮酒、年龄、运动障碍、超敏C反应蛋白(hs-CRP)、 同型半胱氨酸(Hcy)水平及枕叶(左)、颞叶(左)、背侧丘脑、后丘脑、额叶(左)病变部位与AIS 患者确诊 90 d 后认知功能障碍的发生有关。多因素回归分析显示,患者受教育程度、年龄、饮酒、运动障碍、hs- CRP、Hcy、枕叶(左)、背侧丘脑、额叶(左)为AIS 患者90 d 后发生认知功能障碍的危险因素。结论 了解 AIS 患者基本资料、病变部位、同型半胱氨酸及hs-CRP水平等,并采取相应措施,对于降低认知功能障 碍的发生有重要意义。
关键词:  卒中  认知功能障碍  同型半胱氨酸  超敏C 反应蛋白  病变部位
DOI:10.3969/j.issn.1009-6574.2019.01.002
基金项目:国家自然科学基金青年项目(81300040);无锡市卫生计生委科研项目(MS201640)
Multivariate analysis of cognitive dysfunction in patients with acute ischemic stroke 90 days later
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Abstract:
Objective To investigate the main influencing factors of cognitive dysfunction( CD) after acute ischemic stroke( AIS). Methods A total of 160 patients with AIS in Wuxi Branch of Zhongda Hospital Affiliated to Southeast University from January 2015 to January 2018 were selected. The patients were followed up for 90 days. The cognitive function of all patients was evaluated. Logistic regression analysis were applied to analyze the effects of AIS condition, vascular risk factors, serum biochemical indicators, lesion location and other clinical data on the occurrence of CD. Results In this study, 35.0%( 56/160) of 160 AIS patients developed cognitive impairment 90 days later. Increased age, less than 12 years of education, history of alcohol abuse, anemia and dyskinesia all lead to increased incidence of cognitive dysfunction( P< 0.05). Univariate analysis showed that the level of education, alcohol consumption, age, dyskinesia, hypersensitive C-reactive protein( hs-CRP), homocysteine( Hcy), occipital lobe( left), temporal lobe( left), dorsal thalamus, posterior thalamus and frontal lobe( left) were associated with the occurrence of CD in AIS patients 90 days after diagnosis. Multivariate regression analysis showed that education level, age alcohol consumption, dyskinesia, hs-CRP, Hcy, occipital lobe( left), dorsal thalamus and frontal lobe( left) were the risk factors for CD in AIS patients 90 days after diagnosis. Conclusions Understanding the basic information of AIS patients, the location of the lesion and the level of Hcy and hs-CRP in the body, and taking corresponding measures are of great significance to reduce the occurrence of cognitive impairment.
Key words:  Stroke  Cognition disorders  Hcy  hs-CRP  Lesion site

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