急性脑梗死合并认知功能障碍继发血管性痴呆的危险因素分析

Analysis of risk factors for secondary vascular dementia in patients with acute cerebral infarction combined with cognitive impairment

目的探讨急性脑梗死合并认知功能障碍患者继发血管性痴呆的危险因素。方法对2017年7月至2019年7月我院收治的87例急性脑梗死合并认知功能障碍患者进行为期24个月随访调查,通过相关量表收集数据,采用多因素logistic回归分析继发血管性痴呆的危险因素,然后将相关数据代入ROC曲线模型,确定相关评分的诊断界值。结果多因素logistic回归分析显示,合并糖尿病、未进行早期康复护理、简易精神状态评价量表(MMSE)评分、急性生理功能和慢性健康状况评分系统Ⅱ(APACHE-Ⅱ)评分为急性脑梗死合并认知障碍患者2年内发展成血管性痴呆患者的危险因素(P<0.05)。患者入院24 h APACHE-Ⅱ评分最差值≤12分、稳定期MMSE评分≤9分时继发血管性痴呆风险加剧。结论护理人员应对急性脑梗死合并认知功能障碍患者制定早期康复训练计划,延缓或改善认知功能障碍。

Objective To explore the risk factors for secondary vascular dementia in patients with acute cerebral infarction combined with cognitive impairment.Methods To conduct a 24-month follow-up survey for 87 patients with acute cerebral infarction combined with cognitive dysfunction admitted to our hospital from July 2017 to July 2019,we collected data through relevant scales,and analyzed the risk factors of secondary vascular dementia by using multivariate logistic regression,and then the relevant data was substituted into the ROC curve model to determine the diagnostic threshold of the relevant score.Results Multivariate logistic regression analysis showed that the combined diabetes,no early rehabilitation nursing,mini-mental state examination(MMSE)score,acute physiology and chronic health evaluation scoring systemⅡ(APACHE-Ⅱ)score were the risk factors for patients with acute cerebral infarction combined with cognitive impairment who developed into vascular dementia within 2 years(P<0.05).The risk of secondary vascular dementia increased when the worst value of APACHE-Ⅱscore was less than 12 points and the MMSE score was less than 9 points in the stable phase.Conclusion Nursing staff should develop early rehabilitation training plan for patients with acute cerebral infarction combined with cognitive dysfunction to delay or improve cognitive dysfunction.