缺血性脑卒中后血管性认知功能障碍患者相关因素分析

Factors analysis related to vascular cognitive impairment after ischemic stroke

目的探讨缺血性脑卒中后血管性认知功能障碍（VCI）发生的相关因素。方法收集2011年6月至2014年6月入住我院的208例缺血性脑卒中患者的临床资料,其中并发VCI患者82例,非VCI（NVCI）患者126例。分别采用Pearson单因素与多元Logistic回归分析的方法对缺血性脑卒中后并发VCI的相关因素加以确定。结果 （1）经Pearson单因素分析,VCI组与NVCI组在高血压、房颤、血脂异常、NIHSS评分、高糖化血红蛋白、同型半胱氨酸、超敏C反应蛋白及关键部位病灶差异具有统计学意义（P〈0.05,P〈0.01）;（2）经多元Logistic回归分析,影响缺血性脑卒中后VCI的相关因素包括：高糖化血红蛋白（β=1.928,SE=0.382,Wald=6.928,P〈0.05,OR值=2.559,95%CI为1.544-5.782）、高血压（β=2.024,SE=0.195,Wald=7.125,P〈0.01,OR值=2.135,95%CI为1.672-3.225）、高同型半胱氨酸（β=2.359,SE=0.297,Wald=8.567,P〈0.01,OR值=2.687,95%CI为1.938-4.253）、关键部位病灶（β=2.346,SE=0.597,Wald=7.259,P〈0.05,OR值=2.187,95%CI为1.692-3.876）及高超敏C反应蛋白（β=1.856,SE=0.118,Wald=5.358,P〈0.05,OR值=2.102,95%CI为1.432-3.870）。结论 影响缺血性脑卒中后并发VCI的因素较多,应对这些危险因素进行早期干预,降低缺血性脑卒中后VCI的发病率。

Objective To analyze the factors related to vascular cognitive impairment（VCI）after ischemic stroke. Methods Collected the clinical data of 208 cases of patients with ischemic stroke admitted to our hospital from June 2011 to June 2014, including 82 patients with concurrent VCI and 126 without concurrent VCI（NVCI）. Pearson univariate and Logistic multivariate methods were used to determine the factors related to vascular cognitive impairment（VCI） after ischemic stroke. Results（1）By Pearson univariate analysis, VCI group showed statistically significant differences from NVCI group（P〈0.05, P〈0.01） at hypertension, atrial fibrillation, blood cholesterol, NIHSS score, high glycated hemoglobin, homocysteine, high-sensitivity C-reactive protein and key parts of the lesion;（2） By Logistic multivariate analysis, the factors related to vascular cognitive impairment（VCI） after ischemic stroke include： high glycated hemoglobin（β=1.928, SE=0.382, Wald=6.928, P〈0.05, OR value=2.559, 95% CI1.544-5.782）, hypertension（β=2.024, SE=0.195, Wald=7.125, P〈0.01, OR=2.135, 95% CI value of1.672-3.225）, homocysteine（β=2.359, SE=0.297, Wald=8.567, P〈0.01, OR=2.687, 95% CI value of1.938-4.253）, the key parts of the lesion（β=2.346, SE=0.597, Wald=7.259, P〈0.05, OR=2.187, 95% CI value of 1.692-3.876） and superb sensitivity C-reactive protein（β=1.856, SE=0.118, Wald=5.358, P〈0.05,OR=2.102 value, 95% CI of 1.432-3.870）. Conclusion There are a fair amount of factors related to vascular cognitive impairment（VCI） after ischemic stroke, which we should make some early interventions,reducing the incidences of VCI after ischemic stroke.