發(fā)布時(shí)間：2018-02-27 01:17

  本文關(guān)鍵詞： 血管性認(rèn)知功能障礙 危險(xiǎn)因素 缺血性卒中　出處：《浙江大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討缺血性卒中患者急性期發(fā)生認(rèn)知障礙的主要危險(xiǎn)因素。方法:本研究選擇2013年11月至2016年8月就診于浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院等7家醫(yī)院的急性缺血性卒中患者778例,收集患者性別、年齡、受教育程度等一般人口學(xué)信息、血管危險(xiǎn)因素、神經(jīng)體格檢查、磁共振影像數(shù)據(jù)等信息,采用簡(jiǎn)易精神狀態(tài)檢查量表(MMSE)、阿爾茲海默病評(píng)定量表認(rèn)知分量表(ADAS-Cog)評(píng)估患者認(rèn)知功能;根據(jù)認(rèn)知診斷標(biāo)準(zhǔn)將研究對(duì)象分為認(rèn)知正常組(no cognitive impairment,NCI)及血管性認(rèn)知障礙組(vasular cognitive impairment,VCI),VCI 組包括血管性輕度認(rèn)知功能障礙(vascular mild cognitive impairment,VaMCI)及血管性癡呆(vascular dementia,VaD)。運(yùn)用統(tǒng)計(jì)學(xué)方法分析上述各項(xiàng)因素的組間差異及相關(guān)性。結(jié)果:研究共納入778例患者,急性期認(rèn)知障礙發(fā)生率為62.6%,其中血管性輕度認(rèn)知功能障礙290例(37.3%),血管性癡呆197例(25.3%)。多因素Logistic回歸分析顯示,與認(rèn)知正常組相比,高齡、低受教育程度、心臟疾病、嚴(yán)重的神經(jīng)功能缺損、顳葉梗死增加認(rèn)知障礙發(fā)生風(fēng)險(xiǎn)(P0.05)。進(jìn)一步,高齡、低受教育程度、心臟疾病史、嚴(yán)重的神經(jīng)功能缺損、基底節(jié)梗死增加輕度認(rèn)知障礙發(fā)生風(fēng)險(xiǎn)(P0.05);高齡、低受教育程度、嚴(yán)重的神經(jīng)功能缺損、左側(cè)腦梗死、額葉梗死、顳葉梗死增加癡呆發(fā)生風(fēng)險(xiǎn)(P0.05)。結(jié)論:缺血性卒中患者急性期認(rèn)知障礙的發(fā)生率為62.6%,高齡、低受教育程度、心臟疾病、嚴(yán)重的神經(jīng)功能缺損、不同梗死部位及方位是卒中后發(fā)生認(rèn)知障礙的危險(xiǎn)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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 曾瑞;李春芳;劉蕾;杜寧;張軒;陳書麗;薛蓉;;急性缺血性卒中患者血管性認(rèn)知障礙及其亞型的相關(guān)因素分析[J];中國(guó)卒中雜志;2016年04期

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本文編號(hào)：1540497