血管性痴呆危险因素的研究

Study on the risk factors for vascular dementia

目的研究脑梗死后痴呆的危险因素。方法本研究纳入546例脑梗死急性期住院患者,完成随访434例,于住院期间和脑卒中3个月后进行神经心理测试,其中痴呆组118例,非痴呆组316例。运用t检验、χ2检验和logistic回归法分析血管性痴呆的发生率和危险因素。结果本研究中血管性痴呆的发生率为27.2%。单因素分析表明,血管性痴呆组的年龄比非痴呆组高8.5岁,在低教育水平(小学以下)、每日饮酒、脑卒中史等方面的比例显著高于非痴呆组。logistic回归分析表明,年龄、低教育水平、每日饮酒和脑卒中史与血管性痴呆相关。结论血管性痴呆是血管因素和退行性因素共同作用的结果,其中血管因素在血管性痴呆发病机制中起主导作用。年龄、低教育水平、每日饮酒和脑卒中史是血管性痴呆的危险因素。

Objective To examine risk factors for dementia after ischemic stroke in a large stroke cohort in China. Method A total of 546 consecutive patients with ischentic stroke were enrolled in this study, and were examined with MMSE,ADL,POD,RVR, etc, during admission and 3 months after stroke. XZ^2 test, t test and logistic regression analysis were used to evaluate the incidence and to find the risk factors for dementia after ischemic stroke. Results The incidence of dementia after ischemic stroke was 27.2%. The patients with stroke-related dementia more often had old age, low educational level, everyday alcohol drinking and stroke history. The factors associated with stroke-related dementia in logistic regression analysis were age （ OR = 1. 208, 95% CI： 1. 154 - 1. 264）, low educational level （ OR = 1. 902, 95% CI： 1. 067 ～ 3. 390）, stroke history （ OR = 5. 449, 95% CI： 2. 963 ～ 10. 020）, everyday alcohol drinking （ OR = 2. 899, 95% CI ： 1. 287 ～ 6.529）. Conclusions Stroke increases the risk of dementia. Vascular factors play a master role in the pathogenesis of dementia after ischemic stroke. Risk factors for stroke-related dementia are age, low educational level, everyday alcohol drinking and stroke history.