卒中后认知障碍的危险因素分析

Analysis of Risk Factors of Poststroke Cognitive Impairment

目的探讨卒中后发生认知障碍的危险因素。方法回顾性纳入2018年6月-2019年6月邯郸市第一医院神经内科连续收治的急性缺血性卒中患者,采用MMSE、MoCA量表评估认知功能,将其分为卒中后认知障碍(post-stroke cognitive impairment,PSCI)和无认知障碍(no cognitive impairment,NCI)两组,并采用多因素logistic回归模型分析卒中后发生认知障碍的危险因素。结果共纳入162例急性缺血性卒中患者,平均年龄59.79±6.71岁,男性97例(59.9%);PSCI组78例(48.1%),NCI组84例(51.9%)。多因素分析结果显示,初中及以上教育水平(OR 0.153,95%CI0.052~0.454)、既往卒中史(OR 2.915,95%CI 1.262~6.730)、大面积梗死(OR 7.710,95%CI1.591~37.364)、脑萎缩(OR 4.494,95%CI 1.210~16.698)是PSCI的独立影响因素。结论PSCI的发生比例较高;高教育水平是PSCI发生的独立保护因素,既往卒中史、梗死面积大、脑萎缩是PSCI发生的独立危险因素。

Objective To explore the risk factors for poststroke cognitive impairment.Methods The patients with acute ischemic stroke(AIS)who were consecutively admitted to Department of Neurology of the First Hospital of Handan from June 2018 to June 2019 were enrolled in this retrospective study.MMSE and MoCA were used to assess cognitive function,and all the patients were divided into poststroke cognitive impairment(PSCI)group and no cognitive impairment(NCI)group.Multivariate logistic regression model was used to analyze the risk factors for poststroke cognitive impairment.Results A total of 162 AIS patients were included,with an average age of 59.79±6.71 years old and 97 males(59.9%);78 cases(48.1%)in PSCI group,and 84 cases(51.9%)in NCI group.Multivariate analysis showed that high level education(OR 0.153,95%CI 0.052-0.454),stroke history(OR 2.915,95%CI 1.262-6.730),large infarcts(OR 7.710,95%CI 1.591-37.364)and brain atrophy(OR 4.494,95%CI 1.210-16.698)were independent influencing factors for PSCI.Conclusions The incidence of PSCI was relatively high;high level education was an independent protective factor for PSCI,while stroke history,large infarcts,and brain atrophy were independent risk factors for PSCI.