脑胶质瘤患者术前认知功能的影响因素分析

In?uencing factors of pre-operative cognitive function in patients with glioma

目的研究脑胶质瘤患者术前认知功能情况,并分析肿瘤临床特点对认知障碍的影响。方法应用简易智力状态检查量表(mini-mental state examination,MMSE)测评2016年7月-2018年5月于西南医科大学附属医院就诊的100例胶质瘤患者术前认知功能情况,并分析影响胶质瘤患者术前认知功能的因素。结果 100例胶质瘤患者中有60例(60%)术前出现不同程度的认知功能障碍。单因素分析显示,认知功能障碍组较认知功能正常组在MMSE定向力、记忆力、注意力与计算力、回忆力和语言能力KPS评分上有所下降(P均<0.01);认知功能障碍组年龄、肿瘤体积,大于或高于正常组,且左侧肿瘤居多,肿瘤部位与认知功能正常组相比差异有统计学意义(P均<0.05)。Logistic回归分析显示年龄(OR:3.636;95%CI:1.225～10.790)、KPS评分(OR:0.290;95%CI:0.110～0.766)、肿瘤体积(OR:8.731;95%CI:3.508～21.733)、肿瘤侧别(OR:4.736;95%CI:1.846～12.154)为胶质瘤患者认知功能障碍的影响因素(P均<0.05)。结论胶质瘤患者术前存在不同程度的认知障碍,年龄、KPS评分、肿瘤体积、肿瘤侧别等是认知障碍的危险因素。

Objective To explore the pre-operative cognitive function of patients with glioma and in?uencing factors of cognitive impairment. Methods The preoperative cognitive function of 100 glioma patients were analyzed by Mini-mental State Examination(MMSE). Furthermore, the in?uencing factors of the preoperative cognitive function of glioma patients were analyzed. Results Of the 100 patients with glioma, 60 cases had different levels of cognitive impairment preoperatively. Univariate analysis showed that the MMSE scores in cognitive impairment group, including orientation, memory, attention and calculation, recall and language ability were signi?cantly lower than those in normal group(all P < 0.01). Meanwhile, patients’ age, tumor volume, tumor grade in impairment group were signi?cantly higher than those in normal group(all P < 0.05), and more tumors were found in the left side(P < 0.05). Logistic regression analysis showed that age(OR, 3.636;95% CI, 1.225-10.790), KPS score(OR, 0.290;95% CI,0.110-0.766), tumor volume(OR, 8.731;95% CI, 3.508-21.733) and tumor side(OR, 4.736;95% CI, 1.846-12.154) were factors in?uencing cognitive impairment in glioma patients(all P < 0.05). Conclusion There are different levels of cognitive impairment in patients with glioma preoperatively, which may be closely related to age, KPS score, tumor volume, and tumor side.