發(fā)布時(shí)間：2018-08-20 07:35

【摘要】：目的:通過(guò)調(diào)查西寧社區(qū)腦卒中高危人群的認(rèn)知狀態(tài)及其有關(guān)因素,了解其認(rèn)知功能障礙的發(fā)病情況及其影響因素,通過(guò)比較認(rèn)知障礙組和認(rèn)知正常組蒙特利爾認(rèn)知評(píng)估量表總分及各子項(xiàng)得分,探討腦卒中高危人群認(rèn)知障礙的易受損領(lǐng)域及受損程度,希望能為早期控制相關(guān)危險(xiǎn)因素及早期預(yù)防干預(yù)認(rèn)知功能障礙的進(jìn)展,改善腦卒中高危人群的生存狀況提供參考支持。方法:通過(guò)對(duì)居住在西寧市西關(guān)大街社區(qū)40歲以上人群給予腦卒中高危人群篩查和干預(yù)項(xiàng)目風(fēng)險(xiǎn)評(píng)估,選擇腦卒中高危人群且知情同意的258例。應(yīng)用蒙特利爾認(rèn)知評(píng)估量表評(píng)估認(rèn)知狀況,根據(jù)結(jié)果分成認(rèn)知功能障礙組208例,認(rèn)知功能正常組50例。搜集入組人群各項(xiàng)資料,并行血糖、血脂測(cè)定及頸動(dòng)脈彩超檢查,兩組相關(guān)因素進(jìn)行比較,分析各相關(guān)因素與認(rèn)知功能障礙的關(guān)系。結(jié)果:本研究調(diào)查西寧社區(qū)腦卒中高危人群共258例,包括認(rèn)知功能障礙組208例,占總?cè)虢M人數(shù)的80.6%,認(rèn)知功能正常組50例,占總?cè)虢M人數(shù)的19.4%。認(rèn)知功能障礙組與認(rèn)知功能正常組比較,高齡、低教育程度、腦卒中病史、頸動(dòng)脈斑塊比例明顯增高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。將有關(guān)因素進(jìn)行Logistic二元回歸分析:腦卒中病史和年齡≥60歲是腦卒中高危人群認(rèn)知功能障礙的獨(dú)立危險(xiǎn)因素,OR值(95%CI)分別為0.085(0.011~0.651),0.113(1.336~6.546)。入組人群中,具有3、4、5以及≥6個(gè)危險(xiǎn)因素的Mo CA得分分別為(27.74±1.73)分、(27.22±1.66)分、(26.33±1.25)分、(24.33±1.26)分,隨著危險(xiǎn)因素個(gè)數(shù)的增多,其Mo CA得分依次降低,差異有統(tǒng)計(jì)學(xué)意義(F值=49.851,P0.05),分別進(jìn)行兩兩之間的比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。認(rèn)知功能障礙組和認(rèn)知功能正常組相比較,其總分明顯降低,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05),兩組相比,認(rèn)知功能障礙組視空間及執(zhí)行功能、注意、語(yǔ)言、抽象、延遲回憶的子項(xiàng)得分均明顯降低,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05),而兩組在命名、定向方面的得分的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。既往有腦卒中病史組總分低于既往無(wú)腦卒中病史組,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。既往有腦卒中病史組在所有子項(xiàng)的得分均明顯低于無(wú)腦卒中病史組,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1、西寧社區(qū)腦卒中高危人群認(rèn)知功能障礙發(fā)生率較高,腦卒中高危人群隨著危險(xiǎn)因素的增加,其認(rèn)知功能受損程度越重,主要以視空間及執(zhí)行力、注意、語(yǔ)言、抽象、延遲回憶受損為主,而命名和定向力無(wú)明顯受損。2、既往有腦卒中病史的患者與無(wú)腦卒中病史者相比較,其認(rèn)知功能受損情況更為嚴(yán)重,并且其認(rèn)知功能各個(gè)領(lǐng)域均明顯受損。3、高齡、低文化程度、腦卒中病史、頸動(dòng)脈斑塊均可增加腦卒中高危人群出現(xiàn)認(rèn)知功能障礙的風(fēng)險(xiǎn),其中高齡、腦卒中病史是腦卒中高危人群認(rèn)知功能障礙的獨(dú)立危險(xiǎn)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，

本文編號(hào)：2192895