社区脑卒中高危人群非痴呆性血管性认知功能障碍筛查及相关因素分析

Vascular cognitive impairment with no dementia in community subjects with high stroke risk and its relavant factors

目的了解社区脑卒中高危人群认知功能现状及其相关影响因素。方法采用横断面调查方法对天津市河西区4个社区539例脑卒中高危人群进行筛查,采用简易智能状态检查量表及临床痴呆量表评估认知功能,以是否诊断非痴呆性血管性认知功能障碍（VCIND）分为认知正常组401例和认知障碍组138例,比较分析脑卒中高危人群认知功能障碍与脑卒中危险因素的相关性。结果与认知正常组比较,认知障碍组男性（57.2%vs 46.1%）、年龄≥65岁（60.9%vs 39.7%）、高中以下文化程度（87.0%vs 75.1%）、高脂血症（68.8%vs 55.1%）、脑卒中史（34.1%vs 21.7%）、高同型半胱氨酸血症（63.8%vs 53.6%）认知障碍发生率明显升高（P〈0.05,P〈0.01）；高中以下文化程度是影响脑卒中高危人群认知功能的独立危险因素（OR=0.494,95%CI：0.276～0.883,P〈0.05）。结论社区脑卒中高危人群是VCIND的易患人群,提示及早对具有血管性危险因素的社区人群进行认知功能筛查,对防治VCIND的发生具有重要意义。

Objective To investigate the status quo of cognitive function in community subjects with high stroke risk and its relavant influencing factors.Methods Cognitive function of 539subjects with high stroke risk in 4communities of Tianjin was assessed according to the MMSE scale and clinical dementia scale.The subjects were divided into normal cognitive function group（n= 401）and cognitive impairment group（n=138）according to whether they were diagnosed as VCIND.Relation between cognitive function and stroke risk factors in subjects with high stroke risk was analyzed.Results The incidence of cognitive impairment was higher in ≥65years old male subjects with a low educational level,and a history of hyperlipemia,stroke,hyperhomocysteinemia than in those with normal cognitive function（P〈0.05,P〈0.01）,indicating that low educational level is an independent risk factor for cognitive impairment in subjects with high stroke risk（OR=0.494,95%CI：0.276-0.883,P〈0.05）.Conclusion Community subjects are susceptible to VCIND,their cognitive function should thus be examined as early as possible,which is of great impotance for the prevention and treatment of vascular cognitive impairment.