西宁社区脑卒中高危人群认知功能筛查及影响因素分析

发布时间：2018-08-20 07:35

【摘要】：目的:通过调查西宁社区脑卒中高危人群的认知状态及其有关因素,了解其认知功能障碍的发病情况及其影响因素,通过比较认知障碍组和认知正常组蒙特利尔认知评估量表总分及各子项得分,探讨脑卒中高危人群认知障碍的易受损领域及受损程度,希望能为早期控制相关危险因素及早期预防干预认知功能障碍的进展,改善脑卒中高危人群的生存状况提供参考支持。方法:通过对居住在西宁市西关大街社区40岁以上人群给予脑卒中高危人群筛查和干预项目风险评估,选择脑卒中高危人群且知情同意的258例。应用蒙特利尔认知评估量表评估认知状况,根据结果分成认知功能障碍组208例,认知功能正常组50例。搜集入组人群各项资料,并行血糖、血脂测定及颈动脉彩超检查,两组相关因素进行比较,分析各相关因素与认知功能障碍的关系。结果:本研究调查西宁社区脑卒中高危人群共258例,包括认知功能障碍组208例,占总入组人数的80.6%,认知功能正常组50例,占总入组人数的19.4%。认知功能障碍组与认知功能正常组比较,高龄、低教育程度、脑卒中病史、颈动脉斑块比例明显增高,差异有统计学意义(P0.05)。将有关因素进行Logistic二元回归分析:脑卒中病史和年龄≥60岁是脑卒中高危人群认知功能障碍的独立危险因素,OR值(95%CI)分别为0.085(0.011~0.651),0.113(1.336~6.546)。入组人群中,具有3、4、5以及≥6个危险因素的Mo CA得分分别为(27.74±1.73)分、(27.22±1.66)分、(26.33±1.25)分、(24.33±1.26)分,随着危险因素个数的增多,其Mo CA得分依次降低,差异有统计学意义(F值=49.851,P0.05),分别进行两两之间的比较,差异有统计学意义(P0.05)。认知功能障碍组和认知功能正常组相比较,其总分明显降低,其差异具有统计学意义(P0.05),两组相比,认知功能障碍组视空间及执行功能、注意、语言、抽象、延迟回忆的子项得分均明显降低,其差异具有统计学意义(P0.05),而两组在命名、定向方面的得分的差异无统计学意义(P0.05)。既往有脑卒中病史组总分低于既往无脑卒中病史组,其差异具有统计学意义(P0.05)。既往有脑卒中病史组在所有子项的得分均明显低于无脑卒中病史组,其差异具有统计学意义(P0.05)。结论:1、西宁社区脑卒中高危人群认知功能障碍发生率较高,脑卒中高危人群随着危险因素的增加,其认知功能受损程度越重,主要以视空间及执行力、注意、语言、抽象、延迟回忆受损为主,而命名和定向力无明显受损。2、既往有脑卒中病史的患者与无脑卒中病史者相比较,其认知功能受损情况更为严重,并且其认知功能各个领域均明显受损。3、高龄、低文化程度、脑卒中病史、颈动脉斑块均可增加脑卒中高危人群出现认知功能障碍的风险,其中高龄、脑卒中病史是脑卒中高危人群认知功能障碍的独立危险因素。
[Abstract]:Objective: to investigate the cognitive status and its related factors of high risk population of stroke in Xining community, and to understand the incidence of cognitive dysfunction and its influencing factors. By comparing the total scores and sub-items of Montreal Cognitive Assessment scale between the cognitive impairment group and the normal cognitive group, we explored the vulnerable areas and the degree of impairment of cognitive impairment in the high risk population of stroke. It is hoped that it can provide reference support for the early control of related risk factors and the early prevention and intervention of cognitive dysfunction and the improvement of the survival status of the high risk population of cerebral apoplexy. Methods: 258 patients with high risk of stroke and informed consent were selected by screening and risk assessment of intervention project for people over 40 years old who lived in Xining Xiguanjie community. The cognitive status was evaluated by Montreal Cognitive Assessment scale. According to the results, 208 cases of cognitive dysfunction group and 50 cases of normal cognitive function group were divided into two groups. The data were collected, blood glucose, blood lipids and carotid artery color Doppler ultrasound were measured. The correlation factors between the two groups were compared, and the relationship between the related factors and cognitive dysfunction was analyzed. Results: a total of 258 patients with high risk of stroke in Xining community were investigated, including 208 cases of cognitive dysfunction group (80.6%), 50 cases of normal cognitive function group (19.4%). Compared with the normal cognitive function group, the cognitive dysfunction group, the elderly, low education, stroke history, carotid plaque proportion increased significantly (P0.05). Logistic regression analysis showed that stroke history and age 鈮，

本文编号：2192895