缺血性卒中急性期发生认知障碍的主要危险因素分析

发布时间：2018-02-27 01:17

本文关键词： 血管性认知功能障碍危险因素缺血性卒中　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨缺血性卒中患者急性期发生认知障碍的主要危险因素。方法:本研究选择2013年11月至2016年8月就诊于浙江大学医学院附属第一医院等7家医院的急性缺血性卒中患者778例,收集患者性别、年龄、受教育程度等一般人口学信息、血管危险因素、神经体格检查、磁共振影像数据等信息,采用简易精神状态检查量表(MMSE)、阿尔兹海默病评定量表认知分量表(ADAS-Cog)评估患者认知功能;根据认知诊断标准将研究对象分为认知正常组(no cognitive impairment,NCI)及血管性认知障碍组(vasular cognitive impairment,VCI),VCI 组包括血管性轻度认知功能障碍(vascular mild cognitive impairment,VaMCI)及血管性痴呆(vascular dementia,VaD)。运用统计学方法分析上述各项因素的组间差异及相关性。结果:研究共纳入778例患者,急性期认知障碍发生率为62.6%,其中血管性轻度认知功能障碍290例(37.3%),血管性痴呆197例(25.3%)。多因素Logistic回归分析显示,与认知正常组相比,高龄、低受教育程度、心脏疾病、严重的神经功能缺损、颞叶梗死增加认知障碍发生风险(P0.05)。进一步,高龄、低受教育程度、心脏疾病史、严重的神经功能缺损、基底节梗死增加轻度认知障碍发生风险(P0.05);高龄、低受教育程度、严重的神经功能缺损、左侧脑梗死、额叶梗死、颞叶梗死增加痴呆发生风险(P0.05)。结论:缺血性卒中患者急性期认知障碍的发生率为62.6%,高龄、低受教育程度、心脏疾病、严重的神经功能缺损、不同梗死部位及方位是卒中后发生认知障碍的危险因素。
[Abstract]:Objective: to investigate the main risk factors of cognitive impairment in patients with ischemic stroke in acute stage. Methods: from November 2013 to August 2016, we selected 7 hospitals including the first affiliated Hospital of Zhejiang University Medical College. 778 patients with ischemic stroke, Collect general demographic information, blood vessel risk factors, neurophysical examination, magnetic resonance imaging data, and other general demographic information, such as gender, age, education level, etc. The cognitive function of patients was evaluated by MMSE and ADAS-Cog. According to the cognitive diagnostic criteria, the subjects were divided into two groups: normal cognitive group (no cognitive impairment NCII) and vascular cognitive impairment group (Vasular cognitive impairment VCI group), including vascular mild cognitive impairment (VMI) and vascular dementia (VAD). Results: a total of 778 patients were included in the study. The incidence of cognitive impairment in acute stage was 62.6. Among them, 290 patients with vascular mild cognitive impairment and 197 with vascular dementia were found to be involved in this study. Multivariate Logistic regression analysis showed that compared with the normal cognitive group, the patients were older, less educated and had heart disease. Severe neurological impairment, temporal lobe infarction increases the risk of cognitive impairment (P0.05). Further, advanced age, low level of education, history of heart disease, severe neurological impairment, basal ganglia infarction increase the risk of mild cognitive impairment (P0.05). Low level of education, severe neurological impairment, left cerebral infarction, frontal lobe infarction, temporal lobe infarction increased the risk of dementia. Conclusion: the incidence of cognitive impairment in acute phase of ischemic stroke is 62.6%. Heart disease, severe neurological impairment, and different infarct locations are risk factors for cognitive impairment after stroke.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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