孤立性丘脑梗死后发生认知障碍的影响因素分析

Analysis of influencing factors for cognitive impairment after isolated thalamic infarction

目的研究孤立性丘脑梗死患者应用尼麦角林联合醒脑静治疗后发生认知障碍的相关影响因素。方法回顾性分析2020年1月至2022年12月牡丹江医学院附属红旗医院神经内科收治的120例脑梗死患者的临床资料,患者均接受尼麦角林联合醒脑静治疗,统计认知障碍发生情况,整理及分析其相关资料,以多因素logistic回归分析导致认知障碍发生的相关影响因素。结果孤立性丘脑梗死患者的认知障碍发生率为37.50%,单因素分析结果显示,认知障碍患者中年龄≥60岁、高同型半胱氨酸(Hcy)血症、后循环大血管重度狭窄或闭塞、丘脑内侧部梗死占比均高于非认知障碍患者,差异有统计学意义(P<0.05);认知障碍、非认知障碍患者的性别、高血压、糖尿病、高脂血症、卒中史、高尿酸血症、吸烟及饮酒占比比较,差异无统计学意义(P>0.05)。多因素logistic回归分析显示,后循环大血管重度狭窄或闭塞(β=0.513、OR=1.670、95%CI:1.318~2.117)、高Hcy血症(β=0.679、OR=1.972、95%CI:1.247~3.119)以及丘脑内侧部梗死(β=0.427、OR=1.533、95%CI:1.245~1.887)为孤立性丘脑梗死患者发生认知障碍的主要影响因素(P<0.05)。结论后循环大血管重度狭窄或闭塞、丘脑内侧部梗死、高Hcy血症为导致孤立性丘脑梗死后认知障碍的重要因素,临床治疗过程中,需密切监测各指标变化情况,通过合理用药、饮食调节等方式改善病情。

Objective To investigate the relevant influencing factors of cognitive impairment in patients with isolated thalamic infarction treated with nimergoline combined with Xingnaojing.Methods A retrospective analysis was conducted on the clinical data of 120 patients with cerebral infarction admitted to the Department of Neurology,Hongqi Hospital Affiliated to Mudanjiang Medical College from January 2020 to December 2022.All patients received treatment with nimergoline combined with Xingnaojing.The incidence of cognitive impairment was statistically analyzed,and relevant data was organized and analyzed.Multiple logistic regression analysis was used to identify the relevant influencing factors leading to cognitive impairment.Results The incidence of cognitive impairment in patients with isolated thalamic infarction was 37.50%.Univariate analysis showed that the proportion of cognitive impairment patients aged≥60 years,hyperhomocysteinemia(Hcy),severe stenosis or occlusion of posterior circulation large vessels,and medial thalamic infarction were higher than those in non cognitive impairment patients,the differences were statistically significant(P<0.05).There were no significant differences in gender,hypertension,diabetes,hyperlipidemia,stroke history,hyperuricemia,smoking and drinking among patients with cognitive impairment and non-cognitive impairment(P>0.05).Multivariate logistic regression analysis showed severe stenosis or occlusion of posterior circulation large vessels(β=0.513,OR=1.670,95%CI:1.318-2.117),hyperhomocysteinemia(β=0.679,OR=1.972,95%CI:1.247-3.119)and medial thalamic infarction(β=0.427,OR=1.533,95%CI:1.245-1.887)were the main influencing factors for cognitive impairment in patients with isolated thalamic infarction(P<0.05).Conclusion Severe stenosis or occlusion of large blood vessels in the posterior circulation,medial thalamic infarction,and high Hcy are important factors leading to cognitive impairment after isolated thalamic infarction.During clinical treatment,it is necessary to closely monitor changes in various indicators and improve the condition through rational medication and dietary regulation.