急性缺血性脑卒中后认知障碍的危险因素分析

Risk Factors for Cognitive Impairment after Acute Ischemic Stroke

目的明确急性缺血性脑卒中患者发生认知障碍的情况并分析其危险因素。方法根据纳入与排除标准连续收集2017年7月~2018年8月于武汉大学人民医院住院的急性缺血性脑卒中患者104例,所有患者经过MMSE量表评分后分为卒中后认知障碍组(PSCI)及卒中后认知正常组(PSCN),比较两组患者的一般人口学资料、血生化检查结果及卒中病灶部位等指标。结果104例急性缺血性脑卒中患者发生认知障碍的有41例,发生率为39.4%。单因素分析显示两组患者的年龄、血清hs-CRP水平及病灶所在的部位等因素的差异有统计学意义(P<0.05),病灶位于基底节与认知障碍可能相关(P=0.057),多因素Logistic回归分析显示,与PSCN组相比,PSCI组患者的年龄更高(OR=1.087),基底节病灶的发生率也更高(OR=3.935),且两组差异具有统计学意义(P<0.05)。结论急性缺血性脑卒中患者认知障碍发生率较高,高龄和基底节病灶是卒中后认知障碍的独立危险因素。

Objective To illustrate the occurrence of cognitive impairment in patients with acute ischemic stroke and analyze its risk factors.Methods According to the inclusion and exclusion criteria,104 patients with acute ischemic stroke who were hospitalized in Renmin Hospital of Wuhan University from July 2017 to August 2018 were continuously collected.The patients were divided into post-stroke cognitive impairment group(PSCI)and post-stroke cognitive normal group(PSCN)based on their performance on MMSE.General demographic,biochemical and stroke information were compared between the two groups.Results 41 cases out of 104 patients with acute ischemic stroke showed cognitive impairment.The incidence rate was 39.4%.Univariate analysis showed statistically significant differences in age,hs-CRP,and cerebral hemisphere lesions between the two groups of patients(P<0.05).The location of the lesion in the basal ganglia may be related to cognitive impairment(P=0.057).Multivariate logistic regression analysis showed that compared with the PSCN group,patients in the PSCI group were older(OR=1.087),and the incidence of basal ganglia lesions was higher(OR=3.935).The difference between the two groups was statistically significant(P<0.05).Conclusion The incidence of cognitive impairment is higher in patients with acute ischemic stroke.Older age and basal ganglia lesions are independent risk factors for cognitive impairment after stroke.