中等量高血压脑出血患者认知功能障碍的临床特点及影响因素分析

目的探讨中等量高血压脑出血认知功能障碍的临床特点,并分析相关影响因素。方法回顾性分析2019年6月至2021年11月125例中等量高血压脑出血患者的临床资料,收集患者年龄、性别、既往史、吸烟、饮酒、受教育水平、入院时NIHSS评分、出血量、血肿位置、肝肾功能、入院时同型半胱氨酸、炎症标志物(白细胞和C反应蛋白)、血清铁蛋白(FS)、神经元特异性烯醇化酶(NSE)、血脂水平等指标。采用蒙特利尔认知评估量表(MoCA)评估患者发病3个月时的认知功能状态。分析中等量高血压脑出血引起认知功能障碍的影响因素。结果中等量高血压脑出血患者发病3个月时认知功能障碍发生率为52.8%。Logistic回归分析发现年龄、NIHSS评分、出血量、高同型半胱氨酸血症是中等量高血压脑出血认知功能障碍的独立影响因素(P<0.05)。结论中等量高血压脑出血认知功能障碍发病率高。年龄、NIHSS评分、出血量、高同型半胱氨酸血症是认知功能障碍的独立影响因素。

Objective To investigate the clinical characteristics and risk factors of cognitive dysfunction in patients with moderate hypertensive intracerebral hemorrhage.Methods The clinical data of 125 patients with moderate hypertensive intracerebral hemorrhage from June 2019 to November 2021 in the second affiliated hospital of jiaxing university were analyzed.The age,gender,past history,smoking,drinking,educati on level,NIHSS,the amount and location of hematoma,liver and kidney function,homocysteine,inflammatory markers(leukocytes and C-reactive protein),serum ferritin(FS),neuron-specific enolase(NSE),blood lipid levels were collected.The Montreal cognitive assessment scale(MoCA)was used to evaluate the cognitive function status of patients 3 months after onset.The influencing factors of cognitive impairment after moderate to equal amounts of hypertensive intracerebral hemorrhage.Results The incidence of cognitive dysfunction in patients with moderate hypertensive intracerebral hemorrhage was 52.8% 3 months after onset.Multivariate logistic regression analysis found significant differences in age,NIHSS score,hematoma volume,and hyperhomocysteinemia(P<0.05).Conclusion The incidence of cognitive dysfunction in patients with moderate cerebral hemorrhage is high,mainly reflected in the impairment of attention,language,abstraction and memory.Age,NIHSS score,hematoma volume,and homocysteine were independent influencing factors of cognitive impairment.