急性脑卒中患者发生认知障碍的危险因素分析

Analysis of Risk Factors for Cognitive Impairment in Patients With Acute Ischemic Stroke

目的探讨急性脑卒中(acute ischemic stroke,AIS)患者发生认知障碍(post-stroke cognitive dysfunction,PSCD)的危险因素,便于临床制定相应的防治措施。方法回顾性分析2020年1月—2022年1月在福建省立医院治疗的200例AIS患者的临床资料。根据AIS患者PSCD发生情况,将患者分为PSCD组和非PSCD组,采用单因素和Logistic回归分析筛选AIS患者发生PSCD的相关危险因素。结果根据200例急性脑卒中患者PSCD发生情况显示,PSCD发生率为40.50%(81/200);单因素分析结果显示,AIS患者PSCD的发生与性别、高血脂、身体质量指数(body mass index,BMI)、吸烟史、饮酒史以及冠心病等无关,差异无统计学意义(P>0.05);而年龄、文化程度、高血压、糖尿病、体育锻炼以及卒中次数等均与AIS患者PSCD的发生存在相关性,差异有统计学意义(P<0.05);多因素分析结果显示,年龄≥60、初中及以下文化程度、患有高血压、患有糖尿病、不进行体育锻炼均是急性脑卒中患者并发PSCD的独立危险因素。结论AIS患者PSCD的发生与年龄、文化程度、高血压、糖尿病以及体育锻炼相关。临床治疗期间医务人员可结合上述因素制定防治策略,继而对降低AIS患者PSCD的发生及提高AIS患者的临床疗效等具有重要意义。

Objective To investigate the risk factors of poststroke cognitive dysfunction(PSCD)in patients with acute ischemic stroke(AIS),so as to facilitate the clinical development of corresponding prevention and treatment measures.Methods The clinical data of 200 AIS patients treated in Fujian Provincial Hospital from January 2020 to January 2022 were retrospectively analyzed.According to the occurrence of PSCD in AIS patients,the patients were divided into PSCD group and non-PSCD group.Univariate analysis and Logistic regression analysis were used to screen the risk factors of PSCD in AIS patients.Results According to the occurrence of PSCD in 200 patients with acute stroke,the incidence of PSCD was 40.50%(81/200).Univariate analysis showed that the occurrence of PSCD in AIS patients was not related to gender,hyperlipidemia,body mass ind(BMI),smoking history,drinking history and coronary heart disease,with no statistical significance(P>0.05).Age,education level,hypertension,diabetes,physical exercise and stroke frequency were correlated with the occurrence of PSCD in AIS patients,and the differences were statistically significant(P<0.05).Multivariate analysis showed that age≥60,junior high school education or below,hypertension,diabetes and no physical exercise were independent risk factors for PSCD in patients with acute stroke.Conclusion The occurrence of PSCD in AIS patients is related to age,education level,hypertension,diabetes and physical exercise.During clinical treatment,medical staff can combine the above factors to formulate prevention and treatment strategies,which is of great significance to reduce the occurrence of PSCD in AIS patients and improve the clinical efficacy of AIS patients.