中老年初次脑梗死发作后血管性痴呆的相关影响因素分析

发布时间：2018-05-21 18:19

本文选题：中老年 + 初次脑梗死　；参考：《国际神经病学神经外科学杂志》2017年05期

【摘要】：目的探讨中老年脑梗死患者初次发病后出现血管性痴呆(VD)的影响因素。方法收集年龄在45~75岁之间初次发作脑梗死的患者213例,并根据发病3个月后的认知功能情况分为VD组和对照组。对比分析两组患者的一般资料和检查结果,采用单因素及多因素Logistic回归分析筛选出VD的影响因素,并通过ROC曲线分析计量指标的诊断界限值。结果 Logistic回归分析结果显示Hcy(OR=5.921,P0.001)、年龄(OR=6.030,P0.001)、梗死面积(OR=1.372,P0.001)、脑萎缩(OR=5.226,P=0.003)、脑白质病变(OR=1.434,P=0.025)、高血压(OR=2.346,P=0.027)、糖尿病(OR=2.271,P=0.042)、受教育程度(OR=0.195,P0.001)、出院后康复锻炼(OR=0.416,P=0.004)是脑梗死后VD的独立影响因素,其中Hcy的诊断界限值为18.08μmol/L,年龄为61.1岁,梗死面积为5.67 cm2。结论中老年初次脑梗死患者高Hcy、高龄、梗死面积较大、合并有脑萎缩、脑白质病变、高血压及糖尿病可能增大VD的发生风险,受教育程度及康复锻炼则降低发生几率。
[Abstract]:Objective to investigate the influencing factors of vascular dementia (VD) in middle aged patients with cerebral infarction. Methods 213 patients with cerebral infarction aged between 45 and 75 were divided into VD group and control group according to their cognitive function 3 months after onset. By comparing and analyzing the general data and examination results of the two groups, the influencing factors of VD were screened by univariate and multivariate Logistic regression analysis, and the diagnostic limit values of measurement indexes were analyzed by ROC curve. Results the results of Logistic regression analysis showed that the Logistic regression analysis showed that the age of the patients was 5.921n, the age was 6.030g / P 0.001, the infarct area was 1.372g / P 0.001g, the cerebral atrophy was 5.226g / P 0.003, the white matter lesions were 1.434P0.02525, the hypertension was 2.346P0.027n, the diabetes mellitus was 2.271P0.042, the education level was 0.195P0.001and the rehabilitation exercise was 0.0.416P0.004) was the independent factor of VD after cerebral infarction. The diagnostic limit of Hcy was 18.08 渭 mol / L, the age was 61.1 years old and the infarct area was 5.67 cm ~ 2. Conclusion the risk of VD may be increased in the middle and elderly patients with primary cerebral infarction with high Hcy, old age, large infarct size, cerebral atrophy, white matter lesions, hypertension and diabetes, while education level and rehabilitation exercise may decrease the incidence of VD.
【作者单位】：河南省人民医院神经内科;新疆生产建设兵团第十三师红星医院神经内科;
【基金】：河南省科技攻关项目(122102310160)
【分类号】：R749.13

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