日常生活习惯及既往病史对脑梗死后认知障碍的影响研究

Effects on of daily habits and medical history on patients with cognitive impairment after cerebral infarction

目的研究脑梗死后认知障碍患者日常生活习惯及既往病史中的危险因素及保护因素。方法选取2010年12月—2013年12月在京内外共14家单位的神经内科门诊、社区纳入的病例3 000例,分为脑梗死后无认知功能障碍组1 496例和脑梗死后认知功能障碍组1 504例,对患者各项相关病史进行分析。结果单因素分析:年龄、文化程度、高血压病史、脑血管病史、冠心病病史、中风病家族史、红酒、红茶、普洱茶、咖啡、手机、快走、上网、唱歌等因素有、无认知功能障碍组间比较差异有统计学意义(P<0.05,P<0.01)。多因素分析:年龄、有脑血管病史及中风病家族史、饮用红酒或红茶、常打麻将的人群患认知功能障碍的可能性大,成为认知功能障碍的危险因素;而文化程度高、饮用普洱茶、使用手机、进行快走及上网活动者患认知功能障碍的可能性小,认为是认知功能障碍的保护因素。结论脑梗死后认知功能障碍的危险因素较多,针对年龄和家族史等不可控因素,应做到早发现、早预防和早治疗;针对饮酒、饮茶、体育锻炼及促智活动等可控因素,应积极改变不良生活习惯,加强对危险因素的控制。

Objective To study the risk factors and protective factors of daily habits and medical history in patients with cognitive impairment after cerebral infarction. Methods Three thousand cases from neurology clinics and communities of 14 units inside and outside Beijing from December 2010 to December 2013 were selected and divided into two groups,1496 cases in non-cognitive dysfunction group and 1504 cases in cognitive dysfunction group. The relevant medical history were analyzed and researched. Results The results of single factor analysis indicated that the differences were significant between non-cognitive dysfunction group and cognitive dysfunction group in age, degree of education, hypertension history, cerebrovascular disease history, coronary disease history,family history of stroke,red wine,black tea,Pu ＇er tea,coffee,mobile phone,fast walk,net play,singing（ P 〈0. 05,P 〈0. 01）. The results of multiple factors analysis indicated that age,cerebrovascular disease history,family history of stroke,red wine or tea and mah-jongto playing are risk factors for cognitive dysfunction,and the education,use of Pu＇er tea,mobile phones,fast walking and internet activities are protective factors for cognitive dysfunction. Conclusion There are various risk factors for cognitive dysfunction after cerebral infarction. In terms of uncontrollable factors such as age and family history,early diagnosis,early prevention and early treatment are essential. In terms of controllable factors such as drinking,tea,sports,it is necessary to change bad living habits and strengthen the control of risk factors.