急性缺血性卒中患者认知功能障碍影响因素分析

Analysis of Influencing Factors of Cognitive Impairment in Patients With Acute Ischemic Stroke

目的探讨急性缺血性卒中患者认知功能障碍的影响因素。方法选取急性缺血性卒中患者氧化应激水平临床观察研究(Study on Oxidative Stress in Patients with Acute Ischemic Stroke,SOS-Stroke)的3285例患者作为研究对象,采用简易智力状态检查量表(mini-mental state examination,MMSE)测定患者认知功能,急性缺血性卒中患者认知功能障碍的影响因素采用多因素Logistic回归进行分析。结果该研究人群中有869例(26.45%)患有认知功能障碍,患者的年龄、性别、居住地、教育程度、运动情况、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分对急性缺血性卒中后认知功能障碍的影响有统计学意义。高脂血症[比值比(odds ratio,OR)1.38,95%可信区间(confidence interval,CI)1.01~1.89,P=0.043]、女性(OR 1.30,95%CI 1.04~1.63,P=0.020)、NIHSS评分高(OR 1.26,95%CI 1.24~1.30,P<0.001)、居住于农村(OR 1.25,95%CI 1.02~1.53,P=0.026)及高龄(OR 1.03,95%CI 1.02~1.04,P<0.001)是急性缺血性卒中患者认知功能障碍的危险因素,高教育水平(OR 0.77,95%CI 0.63~0.92,P=0.015)和经常运动(OR 0.80,95%CI 0.66~0.97,P=0.020)是其保护因素。结论应综合考虑急性缺血性卒中患者认知功能障碍的影响因素。

Objective To evaluate the influencing factors of cognitive impairment after acute ischemic stroke. Methods The study included 3285 patients who were subjects from the Study on Oxidative Stress in Patients with Acute Ischemic Stroke. The cognitive function of patients were determined by mini-mental state examination （MMSE）, and the influence factors of cognitive impairment in patients with acute ischemic stroke were evaluated in multiple logistic regression analysis. Results The prevalence of cognitive impairment after acute ischemic stroke was 26.46% （n=869）, and the difference between the groups in the aspect of patient＆#39;s age, sex, place of residence, education, exercise, and National Institutes of Health Stroke Scale （NIHSS） score were statistically significant. Logistic regression analysis showed that the risk factors of cognitive impairment after acute ischemic stroke were hyperlipidemia [odds ratio （OR） 1.38, 95% confidence interval （CI） 1.01-1.89, P=0.043）, women （OR 1.30, 95%CI 1.04-1.63, P=0.020）, high National Institutes of Health Stroke Scale （NIHSS） score （OR 1.26, 95%CI 1.24-1.30, P〈0.001）, living in rural areas （OR 1.25, 95%CI 1.02-1.53, P=0.026） and advanced age （OR 1.03, 95%CI 1.02-1.04, P〈0.001）. High education level （OR 0.77, 95%CI 0.63-0.92, P=0.015） and frequent exercise （OR 0.80, 95%CI 0.66-0.97, P=0.020） wereprotective factors. Conclusion We should comprehensively take into account the influencing factors of cognitive impairment in patients with acute ischemic stroke.