急性脑梗死患者早期认知障碍危险因素研究

Study on the influencing factors of early cognitive impairment in acute ischemic stroke among the patients

目的脑梗死后认知障碍是导致生活质量下降的重要原因。本文研究急性脑梗死(AIS)患者临床及实验室资料,探索其与认知障碍之间的关系,以期预测脑梗死后认知障碍的相关风险。方法选取2021年1月-2022年12月在河北省人民医院神经内科住院的AIS患者作为研究对象,使用蒙特利尔认知量表测评,分为认知障碍组和非认知障碍组,收集研究对象的一般资料、临床资料、实验室资料等,采用二元Logistic回归分析AIS住院后患者认知障碍的影响因素。结果共纳入161例AIS患者,认知障碍组与非认知障碍组相比,年龄、受教育年限、脑卒中病史差异有统计学意义(P<0.05);认知障碍组中性粒细胞/淋巴细胞比值(NLR)、三酰甘油、总胆固醇、尿酸、同型半胱氨酸(Hey)均高于认知正常组,差异有统计学意义(P<0.05);二元Logistic回归分析显示受教育年限[OR=1.27,95%CI(1.008,1.599)]、Hcy水平[OR=0.704,95%CI(0.59,0.839)]是脑梗死后认知障碍的独立危险因素。结论年龄、受教育年限、脑卒中病史、NLR、三酰甘油、总胆固醇、尿酸、同型半胱氨酸(Hcy)是脑梗死后认知障碍的相关危险因素,其中受教育年限、高同型半胱氨酸(Hhcy)水平是脑梗死患者出现认知障碍的独立危险因素。

Objective Cognitive impairment after ischemic stroke is an important cause of decreased life quality after acute ischemic stroke(AIS),but there is a lack of effective treatment all over the world.Therefore,evaluating patients'clinical elements to predict the risk of cognitive impairment after AIS is very crucial.Clinical and laboratory data of AIS patients were collected to investigate their relationship with cognitive impairment in order to predict the risk of cognitive impairment after AIS.Methods Patients with AIS who were hospitalized in the Department of Neurology of Hebei General Hospital from January 2021 to December 2022 were selected as the research objects.The patients were divided into cognitive impairment group and non-cognitive impairment group by using montreal cognitive assessment.The general,clinical and laboratory data of hospitalized patients were collected,and the influencing factors of cognitive impairment were analyzed by binary Logistic regression.Results 161 AIS patients were included.There were statistically significant differences in age,years of education and stroke history between the cognitive impairment group and the non-cognitive impairment group(P<0.05).NLR,triglyceride,total cholesterol,uric acid and homocysteine in cognitive impairment group were higher than those in cognitive normal group,and the dfference was statistically significant(P<0.05).Binary Logistic regression analysis showed that years of education[0R=1.27,95%CI(1.008,1.599)]and homocysteine level[0R=0.704,95%CI(0.59,0.839)]were independent risk factors for cognitive impairment after AIS.Conclusion Age,years of education,stroke history,NLR,triglyceride,total cholesterol,uric acid and homocysteine are risk factors for cognitive impairment after AIS.Years of education and high homocysteine level are independent risk factors for cognitive imp airment in patients with AIS.