轻型急性脑梗死后患者认知域功能的变化及认知功能障碍的危险因素分析

Changes of cognitive domain function and risk factors of cognitive dysfunction in patients with mild acute cerebral infarction

目的探讨轻型急性脑梗死后患者认知域功能的变化及认知功能障碍(CI)的危险因素。方法选取我院195例轻型急性脑梗死患者设为梗死组,50例健康体检者设为对照组,比较两组不同梗死部位的不同认知域评分;依据蒙特利尔认知评估量表(MoCA)评分将梗死组患者分为CI组(150例)和非CI组(45例),比较两组患者的一般资料,多因素分析影响轻型急性脑梗死后患者CI的危险因素;采用受试工作者特征曲线(ROC)和校准曲线评价人工神经网络模型的区分度和准确度。结果梗死组患者较对照组认知区域功能下降(P<0.05);多因素Logistic分析结果显示,女性、糖尿病、高血压、HBS-SP≤55分为轻型急性脑梗死后患者发生CI的独立危险因素,而文化程度高为保护因素(P<0.05)。ROC曲线和校准曲线显示该模型具有较好的区分度和准确度。结论临床应重点关注绝经期女性、患者HBS-SP评分等危险因素,以预防和减缓CI发生。

Objective To investigate the changes of cognitive domain function and risk factors of cognitive dysfunction(CI)in patients with mild acute cerebral infarction.Methods A total of 195 patients with mild acute cerebral infarction in our hospital were selected as the infarction group,and 50 healthy subjects were selected as the control group.The cognitive domains scores of different infarct sites were compared between the two groups.According to the Montreal Cognitive Assessment Scale(MoCA)score,the infarction group was divided into CI group(150 cases)and non-CI group(45 cases),and the general data of the two groups were compared.Multifactorial analysis of risk factors affecting CI in patients with mild acute cerebral infarction.The Receiver Operating Characteristic(ROC)and calibration curve were used to evaluate the discrimination and accuracy of the artificial neural network model.Results Compared with the control group,the cognitive function of infarct group decreased(P<0.05).CI rate of mild acute cerebral infarction was 76.92%(150/195).Multivariate Logistic analysis showed that female,diabetes mellitus,hypertension and HSS-SP≤55 were independent risk factors for CI in patients with mild acute cerebral infarction,while high education level was a protective factor(P<0.05).ROC curve and calibration curve show that the model has good discrimination and accuracy.Conclusion Clinical attention should be paid to menopausal women,patients HBS-SP score and other risk factors to prevent and slow down the occurrence of CI.