急性脑梗死患者血管性认知功能障碍的影响因素分析

doi:10.3969/j.issn.1006-6233.2018.05.037

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摘要 目的:观察急性脑梗死患者血管性认知功能障碍(VCI)的危险因素。方法:将100例急性脑梗塞患者按照是否存在血管性认知功能障碍分为VCI组64例和无VCI组36例。对引起急性脑梗死患者认知功能障碍的单因素及多因素进行分析。结果:两组急性脑梗死患者在房颤、饮酒、吸烟等相关因素方面并无太大差异。在颈动脉粥样硬化、原发性高血压、脑白质疏松、糖尿病以及血清同型半胱氨酸(Homocysteine,Hcy)浓度等方面,两组差异有统计学意义(P<0.05)。多因素Logistic回归显示:血清Hcy浓度(OR=0.520,95%Cl:1.120~1.014,P=0.001)、脑白质疏松(OR=6.833,95%Cl:2.474~12.365,P=0.002)、原发性高血压(OR=2.671,95%Cl:1.031~7.120,P=0.011)、颈动脉粥样硬化(OR=3.319,95%Cl:1.225~8.669,P=0.040)、糖尿病(OR=7.131,95%Cl:2.029~19.322,P=0.001)均与急性脑梗死患者是否存在VCI密切相关。结论:对急性脑梗死患者来说,糖尿病、颈动脉粥样硬化、原发性高血压、脑白质疏松、血清Hcy浓度可视为认知功能障碍的提示因子。

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	赵建国

关键词 ：急性脑梗死, 血管性认知功能障碍, 同型半胱氨酸, 原发性高血压, 糖尿病

Abstract：Objective: To observe the risk factors of vascular cognitive impairment(VCI) in acute cerebral infarction patients. Methods: A total of 100 cases of acute cerebral infarction patients were divided into VCI group (64 cases) and non-VCI group (36 cases) according to the presence of VCI. Then single factor and multi-factor analysis were implemented in the VCI among acute cerebral infarction patients. Result: No statistical significance was observed in smoking, drinking and arterial fibrillation between the two groups (p>0.05); while the statistical significances were obtained in comparisons of carotid artherosclerosis, primary hypertension, leukoaraiosis, diabetes and serum Hcy level between groups (p<0.05). The multivariable Logistic regression model revealed that the serum Hcy level [OR=0.520,95%Cl:1.120~1.014,P=0.001], leukoaraiosis [OR=6.833,95%Cl:2.474~12.365,P=0.002], primary hypertension[OR=2.671,95%Cl:1.031~7.120,P=0.011], carotid artherosclerosis [OR=3.319,95%Cl:1.225~8.669,P=0.040] and diabetes [OR=7.131,95%Cl:2.029~19.322,P=0.001] were all closely related to the presence of VCI in acute cerebral infarction patients. Conclusion: For patients with acute cerebral infarction, theses conditions such as diabetes, carotid atherosclerosis, primary hypertension, leukoaraiosis, and serum Hcy concentration may be considered as a hint for cognitive dysfunction.

Key words： Acute cerebral infarction Vascular cognitive impairment Risk factors Homocysteine Primary hypertension Diabetes mellitus

基金资助:国家重点研发计划“精准医学研究”重点专项,(编号:2016YFC0901000)

引用本文:

赵建国. 急性脑梗死患者血管性认知功能障碍的影响因素分析[J]. 河北医学, 2018, 24(5): 841-843.
ZHAO Jianguo. Analysis of the Influence Factors of Vascular Cognitive Impairment in Acute Cerebral Infarction Patients. HeBei Med, 2018, 24(5): 841-843.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.05.037 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I5/841