老年人血管性认知功能障碍影响因素分析

Impact factors of vascular cognitive impairment among the elderly stroke patients

目的探讨老年人血管性认知功能障碍(VCI)的影响因素,为采取有效的干预措施提供参考依据。方法收集2013年3月—2017年3月牡丹江医学院红旗医院收治的200例年龄>60岁老年脑梗塞或者脑出血患者,根据认知功能评定结果将其分为VCI组(79例)和非VCI组(121例),采用多因素非条件logistic回归分析方法分析VCI发生的影响因素。结果 VCI组和非VCI组患者在年龄、文化程度、婚姻状况、睡眠状况、食用肉类情况、饮茶情况及有无高血压、糖尿病、冠心病方面差异均有统计学意义(均P<0.05);VCI组患者在同型半胱氨酸(Hcy)和超敏C反应蛋白(hs-CRP)分别为(20.18±3.62)μmol/L和(6.80±1.13)mg/L,均高于非VCI组患者的(12.72±1.59)μmol/L和(2.31±1.02)mg/L,血管内皮生长因子(VEGF)为(180.26±21.37)pg/m L,低于非VCI组患者的(226.53±24.28)pg/m L,差异均有统计学意义(均P<0.001);多因素非条件logistic回归分析结果显示,年龄≥70岁、高血压、Hcy和hs-CRP水平较高是老年人VCI发生的危险因素,初中及以上文化程度、每天饮茶和VEGF水平较高是老年人VCI发生的保护因素。结论年龄、文化程度、饮茶情况、有无高血压及Hcy、VEGF、hsCRP水平是老年人VCI发生的主要影响因素。

Objective To investigate influencing factors of vascular cognitive impairment （VCI） in elderly stroke patients and to provide references for effective interventions on VCI. Methods We recruited 200 cerebral infarction or hemorrhage patients older than 60 years at a general hospital in Mudanjiang city and assigned the patients into a VCI group （n =79） and a non-VCI group （n = 121 ） based on the results of cognitive function assessment. We conducted a questionnaire survey and laboratory test among the participants and adopted unconditional multivariate logistic regression to explore factors related to VCI among the participants. Results There were significant differences in age,marital sta- tus, educational level, sleep status, meat intake, tea drinking, hypertension, diabetes mellitus, and coronary heart disease between VCI group and non-VCI group （ P 〈 0. 05 for all ）. In comparison to those in the non-VCI group, significantly higher homocysteine （Hcy） （20. 18 _＋3.62 vs. 12.72 _＋ 1.59 ~mol/L） and hypersensitive C-reactive protein （hs-CRP） （6. 80 _＋ 1.13 vs. 2. 31 _＋ 1.02 mg/L） and lower vascular endothelial growth factor （VEGF） （180. 26 _＋21.37 vs. 226. 53 _＋ 24. 28 pg/mL） were detected in the VCI group （P 〈 0. 001 for all）. The results of unconditional logistic regression re- vealed that aged 70 years and above,hypertension, high levels of Hcy and hs-CRP were risk factors of VCI;while educa- tion of junior high school or above, drinking tea every day, and high level of VEGF were protective factors against VCI. Conelusion Age, educational level, tea drinking, whether with hypertension, and Hcy, VEGF and hs-CRP levels are main influencing factors of VCI among elderly stroke patients.