急性脑梗死患者早期认知功能障碍的相关危险因素

Risk factors of early cognitive impairment in patients with acute cerebral infarction

目的探讨和分析急性脑梗死患者发生认知功能障碍的相关危险因素。方法选取2016年8月—2019年8月辽宁省金秋医院急性脑梗死患者148例为研究对象。根据简易智力状态检查量表(MMSE)评分分为认知障碍组(71例)和认知正常组(77例)。比较两组临床资料,多因素分析采用logistic回归分析。结果两组年龄、脑卒中史、糖尿病史、颈动脉斑块、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数、脑梗死牛津郡社区卒中项目(OCSP)分型、梗死病灶数量比较,差异均有统计学差异(均P<0.05)。年龄≥65岁(OR=4.400,95%CI:1.791~10.809,P=0.001),颈动脉斑块(OR=3.361,95%CI:1.151~9.815,P=0.027),NIHSS评分≥5分(OR=3.205,95%CI:1.094~9.386,P=0.034),OCSP前循环梗死型(OR=2.378,95%CI:1.111~5.090,P=0.026),脑卒中史(OR=2.284,95%CI:1.026~5.088,P=0.043),多发梗死病灶(OR=2.151,95%CI:1.003~4.613,P=0.049)是认知障碍的危险因素。结论高龄、颈动脉斑块、NIHSS评分、脑卒中史、OCSP分型及脑梗死病灶数量可能是急性脑梗死患者认知功能障碍的独立危险因素。

Objective To explore the risk factors of early cognitive impairment in patients with acute cerebral infarction.Methods From August 2016 to August 2019,a total of 148 patients with acute cerebral infarction in Jin Qiu Hospital of Liaoning Province were involved as study objects.According to mini-mental state examination(MMSE),they were divided into cognitive impairment group(71 cases)and cognitive normal group(77 cases).The clinical data of two groups were compared;and multivariate analysis was performed using logistic regression analysis.Results There were statistically significant differences in age,stroke history,diabetes history,carotid artery plaque,national institutes of health stoke scale(NIHSS)score,Barthel index,cerebral infarction type of Oxfordshire community stroke project(OCSP)and infarction lesions number between the two groups(all P<0.05).Age≥65 year olds(OR=4.400,95%CI:1.791-10.809,P=0.001),carotid artery plaque(OR=3.361,95%CI:1.151-9.815,P=0.027),NIHSS score≥5 points(OR=3.205,95%CI:1.094-9.386,P=0.034),OCSP anterior circulation infarction(OR=2.378,95%CI:1.111-5.090,P=0.026),stroke history(OR=2.284,95%CI:1.026-5.088,P=0.043)and multiple cerebral infarction(OR=2.151,95%CI:1.003-4.613,P=0.049)were risk factors for cognitive impairment.Conclusion The advanced age,carotid artery plaque,NIHSS score,OCSP type,stroke history and cerebral infarction number are independent risk factors for early cognitive impairment after acute cerebral infarction.