脑损伤急性应激障碍患者轻度认知障碍的影响因素

The influencing factors of mild cognitive impairment patients with acute stress disorder of brain injury

目的:探讨脑损伤急性应激障碍患者轻度认知障碍的危险因素。方法:对2017年4-10月华北理工大学附属医院住院的脑损伤患者急性应激障碍认知正常患者316例和脑损伤患者急性应激障碍轻度认知障碍患者158例,采用斯坦福急性应激反应问劵(SASRQ)、简易精神状态检查量表(MMSE)和一般人口学资料对患者进行评测。结果:474例脑损伤急性应激障碍患者MMSE得分为(20.76±5.734),多因素Logistic回归分析显示,男性(OR=0.254,95%CI为0.140～0.461),外向(OR=0.219,95%CI为0.117～0.407),月收入大于5000元(OR=0.545,95%CI为0.304～0.974),脑体力相结合(OR=0.063,95%CI为0.006～0.637),无高血压(OR=0.417,95%CI为0.243～0.714),无噩梦(OR=0.355,95%CI为0.202～0.624),不易怒(OR=0.141,95%CI为0.076～0.260)是脑损伤患者发生MCI的保护因素(P<0.05);小学及以下文化(OR=5.146,95%CI为2.494～10.619),偏瘫(OR=2.035,95%CI为1.202～3.444)是脑损伤急性应激障碍发生MCI的危险因素(P<0.05)。结论:脑损伤急性应激障碍患者存在明显的轻度认知障碍,低文化水平、偏瘫、高血压、噩梦、易怒是脑损伤急性应激障碍患者发生MCI的危险因素。

Objective:To explore the risk factors of mild cognitive impairment patients with acute stress disorder of brain injury.Methods:158 mild cognitive impairment patients with acute stress disorder of brain injury and 316 normal cognitive function patients with acute stress disorder of brain injury who hospitalized at North China University of Science and Technology affiliated hospital between April of 2017 and October of 2017 were collected,and they were measured by using Stanford Acute Stress Reaction Questionnaire(SASRQ),Mini-mental State Examination(MMSE)and general demographic data.Results:Among the 474 acute stress disorder of brain injury patients,the average MMSE score was(20.76±5.734).Multivariate logistic regression analysis showed that male((OR=0.254,95%CI:0.140~0.461)),extroversion(OR=0.219,95%CI:0.117~0.407),the monthly income over 5000(OR=0.545,95%CI:0.304~0.974),combination of brain and physical strength(OR=0.063,95%CI:0.006~0.637),no hypertension(OR=0.417,95%CI:0.243~0.714),no nightmare(OR=0.355,95%CI:0.202~0.624),no irritability(OR=0.141,95%CI:0.076~0.260)were protective factors of acute stress disorder in patients with acute stress disorder of brain injury(P<0.05).Literacy in primary school and below(OR=5.146,95%CI:2.494~10.619),hemiplegic paralysis(OR=2.035,95%CI:1.202~3.444)were risk factors of acute stress disorder in brain injury patients(P<0.05).Conclusion:The patients with acute stress disorder of brain injury have severe mild cognitive impairment,low educational level,hemiplegic paralysis,hypertension,nightmare and irritability are risk factors of acute stress disorder in brain injury patients.