急性缺血性脑卒中非痴呆病人早期认知失调的研究与评价

Research and Evaluation of Early Cognitive Dissonance in Acute Ischemic Stroke Without Dementia

目的对早期认知失调的急性缺血性脑卒中非痴呆患者进行临床研究,探讨早期认知失调的影响因素。方法选取该院2009年5月—2014年5月期间收治的280例急性缺血性脑卒中非痴呆患者,发病入院2周后对所有患者进行简短精神状态量表(Mini-Mental State Examination,MMSE)测评,根据评分分为>27分认知正常组患者和<27分认知失调组患者。对比两组患者可能引起认知失调的相关因素进行。结果对两组患者基本资料进行分析发现,正常组与失调组患者在年龄、文化程度以及房颤等因素方面存差异有统计学意义(P<0.05);在分析各评分指标时发现,两组患者SAS,SDS评分差异有统计学意义(P<0.05);入院时NIHSS评分两组患者差异无统计学意义(P<0.05);而入院后14 d两组患者NIHSS评分差异有统计学意义(P<0.05),结论年龄、文化程度以及房颤等因素是影响急性缺血性脑卒中非痴呆患者早期认知失调的影响因素,而入院时患者心理状况以及脑卒中造成的神经功能缺损严重程度也与患者认知失调密切相关。临床上应尤其注意此类患者的治疗。

Objective To study the early cognitive dissonance in acute ischemic stroke without dementia clinically and explore the factors influencing the early cognitive dissonance.Methods 280 acute ischemic stroke patients without dementia admitted in our hospital from May 2009 to May 2014 were selected. All the patients underwent Mini-Mental State Examination （MMSE） evaluation 2 weeks after admission. Then in accordance with the scores, they were divided into two groups, normal cognition group with more than 27 points and cognitive dissonance group with less than 27 points. And the related factors might cause the cognitive dissonance in both groups were analyzed.Results The analysis of the basic data of both groups showed that, there was significant difference in age, cultural level, atrial fibrillation and other factors between the two groups,P〈0.05; it was found by the analysis of the score indexes that the differences in SAS and SDS scores between the two groups were significant,P〈0.05; no difference in the NIHSS score existed between the two groups at admission, P〉0.05; while there was significant difference in the NIHSS score between the two groups 14d after admission,P〈0.05.Conclusion Age, culture level, atrial fibrillation and other factors are the factors influencing early cognitive dissonance in acute ischemic stroke patients without dementia. And the status of psychology and the severity of neurological impairment caused by ischemic stroke at admission are closely related to the early cognitive dissonance, so the treatment of this kind of patients should be paid special attention in clinical practice.