患者疾病感知对缺血性脑卒中预后的影响

Influence of illness perception on prognosis of patients with ischemic stroke

目的探讨缺血性脑卒中患者或其家属的疾病感知水平对预后的影响。方法选取2014年1—8月该院神经内科收治的345例首发缺血性脑卒中患者进行疾病感知水平调查,根据其感知水平高低分为低水平组(112例)、中水平组(117例)、高水平组(116例),采用美国国立卫生研究院卒中量表(NIHSS)、日常生活能力量表(ADL)分别在治疗前及治疗后第1、2周对三组患者进行测评。患者出院后1、3个月门诊随访,并进行神经系统检查及量表评定。分析三组间神经功能评分与感知水平的关系。结果三组患者NIHSS评分均有降低,ADL评分均有提高,高水平组患者神经功能缺损改善程度最高,中水平组患者NIHSS和ADL评分均优于低水平组,差异均有统计学意义(P<0.05)。结论患者或其家属对缺血性脑卒中的疾病感知程度影响预后,疾病感知水平高者,治疗后神经功能恢复更好。应采取干预措施提高患者疾病认知水平,从而改善缺血性脑卒中的预后。

Objective To explore the influence of illness perception on prognosis of patients with ischemic stroke and patients′ relatives. Methods A total of 345 patients with initial ischemic stroke in Neurology Department of Nanchuan People ′s Hospital from January to August 2014 were selected and investigated on the level of illness perception. The patients were divided into three groups [low-level group（n=112）,medium-level group（n=117） and high-level group（n=116）] according to the levels of illness perception. The National Institutes of Health Stroke Scale（NIHSS） and activity of daily living（ADL） were adopted for e val uation in the three groups before treatment and 1st and 2nd week after treatment. All the patients received follow-up visit on1 st and 3rd month after discharge,meanwhile the neurological examination and scale evaluation were applied. The relationship of neurological score and perception level in the three groups were analyzed. Results The NIHSS score in all the three groups declined,ADL scores increased,the improvement degree of neurologic impairment in the high-level group was higher than that in the other two groups,the NIHSS and ADL in the medium-level group was superior to those in the low-level group,and the differences all had statistical significance（P〈0.05）. Conclusion The levels of illness perception of patients and family member affect the prognosis,and the patients with higher level of illness perception are with better neural functional recovery after treatment. Inter-vention measures should be taken to increase the cognitive level towards the disease of the patients,in order to improve the prognosis of ischemic stroke.