脑梗死后情感障碍和认知障碍的影响因素

The factors influencing the emotional and cognitive impairments after cerebral infarction

目的探讨脑梗死后情感障碍和认知障碍的影响因素,以及脑神经功能部位损害与其情感障碍和认知障碍的相关性。方法收集首发脑梗死患者189例,再发脑梗死234例和正常对照56名,分别应用韦氏成人智力量表和Hamilton焦虑量表和17项版本抑郁量表进行认知功能测定、情感测定。结果189例首发脑梗死患者中,有认知障碍者103例(54.5%),有焦虑障碍者125例(66.1%),有抑郁障碍者128例(67.7%);234例再发脑梗死患者中,有认知障碍者169例(72.22%),有焦虑障碍者179例(76.5%),有抑郁障碍者185例(79.1%);脑梗死后认知障碍的影响因素是患者的焦虑-抑郁障碍、文化程度、职业、脑梗死部位、数量、有无白质病变和脑萎缩程度;脑梗死后情感障碍的影响因素是认知功能障碍、脑梗死部位、数量、有无白质病变和脑萎缩程度。焦虑抑郁障碍可明显影响患者的认知功能。结论多种因素可影响脑卒中患者的情感障碍和认知障碍,而且两者的相互影响和作用可明显降低患者的治疗效果和生活质量。

Objective To investigate the factors influencing the emotional and cognitive impairments in patients after cerebral infarction. Methods One hundred eighty-nine patients with first cerebral infarction, 234 patients with recurrent cerebral infarction and 56 age matched normal controls were studied. The cognitive function and emotion status were tested using Wechsler adult intelligence scale （WAIS） , Hamilton Anxiety Scale and 17-item Depression Scale. Results Of the 189 cases of first cerebral infarction, 103 had intellectual Impairment （54. 5% ）, 125 anxiety （66. 1% ）, and 128 depression （67.7%）. Of the 234 cases with the recurrent cerebral infarction, 169 had intellectual Impairment （72. 22% ）, 179 anxiety （72. 22% ）, and 185 depression （76.5%）. The main factors influencing the cognitive impairment were anxiety and depression disorders, education, occupation, location and quantity of cerebral infarction, white matter lesion, and brain atrophy. The main factors influencing the emotion disorders were cognitive impairment, location and quantity of cerebral infarction, white matter lesion, and brain atrophy. Anxiety or/and depression significantly influenced the cognitive function of patients with cerebral infarction. Conclusions Many factors can influence the emotional and cognitive functions of the patients with cerebral infarction. Emotional and cognitive impairments after cerebral infarction can influence each other, which may decrease the therapeutic efficacy and quality of Life of patients with cerebral infarction.