缺血性脑卒中出现脑白质疏松和认知障碍的风险分析

Risk analysis of leukoaraiosis and cognitive impairment in patients with ischemic stroke

目的:探讨缺血性脑卒中患者出现脑白质疏松和认知障碍的危险因素。方法:选择2018年6月~2020年6月江门市人民医院神经内科收治的缺血性脑卒中患者97例,根据患者是否出现脑白质疏松和认知障碍分为观察组(出现脑白质疏松和认知障碍)36例和对照组(未出现脑白质疏松和认知障碍)61例。分析缺血性脑卒中患者出现脑白质疏松和认知障碍的情况,并采用Logistic多因素回归分析危险因素。结果:97例患者中有36例患者出现脑白质疏松和认知障碍,LA评分平均为(5.95±1.12)分,MMSE评分平均为(17.34±3.09)分,其中LA分级:轻度10例,中度18例,重度8例;认知障碍分级:轻度12例,中度19例、重度5例。单因素分析结果显示,高血压、高血脂、冠心病、糖尿病、饮酒、吸烟是影响缺血性脑卒中患者出现脑白质疏松和认知障碍的因素(P<0.05)。Logistic回归分析结果显示,高血压、高血脂、冠心病是影响缺血性脑卒中患者出现脑白质疏松和认知障碍的独立危险因素(P<0.05)。结论:高血压、高血脂、冠心病是影响缺血性脑卒中患者出现脑白质疏松和认知障碍的独立危险因素,临床应严格掌握危险因素,给予积极干预及治疗,以防治缺血性脑卒中患者出现脑白质疏松和认知障碍。

Objective To explore the risk factors of leukoaraiosis and cognitive impairment in patients with ischemic stroke.Method From June 2018 to June 2020,97 patients with ischemic stroke were selected.The patients were divided into observation group(36 cases with leukoaraiosis and cognitive impairment)and 61 cases in control group(without leukoaraiosis and cognitive impairment).The incidence of leukoaraiosis and cognitive impairment in patients with ischemic stroke was analyzed,and the risk factors of leukoaraiosis and cognitive impairment after ischemic stroke were analyzed by logistic regression.Results 36 of the 97 patients had leukoaraiosis and cognitive impairment.The average LA score was(5.95±1.12)points,and the average MMSE score was(17.34±3.09)points.LA classification:10 cases of mild,18 cases of moderate,and 8 cases of severe.cognitive impairment classification:12 cases of mild cognitive impairment,19 cases of moderate and 5 cases of severe cognitive impairment.Univariate analysis showed that hypertension,hyperlipidemia,coronary heart disease,diabetes,drinking and smoking were the factors influencing leukoaraiosis and cognitive impairment in patients with ischemic stroke(P<0.05).Logistic regression analysis showed that hypertension,hyperlipidemia and coronary heart disease were independent risk factors for leukoaraiosis and cognitive impairment in patients with ischemic stroke(P<0.05).Conclusion Hypertension,hyperlipidemia and coronary heart disease are independent risk factors for leukoaraiosis and cognitive impairment in patients with ischemic stroke.We should strictly grasp the risk factors and give active intervention and treatment in order to prevent leukoaraiosis and cognitive impairment in patients with ischemic stroke.