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| 弥漫性轴索损伤认知功能障碍的临床特点及影响因素分析 | |
| 引用本文： | 沈和平,王耿焕,尹汉奎. 弥漫性轴索损伤认知功能障碍的临床特点及影响因素分析[J]. 中华全科医学, 2020, 18(2): 246-248. DOI: 10.16766/j.cnki.issn.1674-4152.001216 |
| 作者姓名： | 沈和平 王耿焕 尹汉奎 |
| 作者单位： | 1. 嘉兴学院附属第二医院神经内科, 浙江 嘉兴 314000; |
| 基金项目： | 浙江省医药卫生科技计划项目(2018YK802)嘉兴市科技局项目(2014AY21038) |
| 摘 要： | 目的 分析弥漫性轴索损伤(diffuse axonal injury,DAI)患者认知功能障碍的临床特点,探讨影响认知功能障碍的相关因素,为早期干预提供临床依据。 方法 根据纳入及排除标准收录2016年1月—2018年1月在嘉兴学院附属第二医院治疗的DAI患者85例,收集患者基线信息,包括人口学信息、入院格拉斯哥评分(Glasgow coma scale,GCS)、昏迷时间、是否手术、是否合并其他部位损伤、高血压病、糖尿病、吸烟、饮酒、院内感染等资料。利用蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)评估DAI患者受伤3个月时的认知功能状态,再进行t检验、χ2检验及多因素logistic回归分析。 结果 85例DAI患者中62例出现认知功能障碍,患病率为72.9%,认知功能障碍以注意力、抽象思维、延迟记忆等方面损害为主(t值分别为9.004、12.424、7.423,均P<0.001),多因素logistic回归分析表明,年龄、昏迷时间对整体认知功能影响有统计学意义,OR值分别为1.842、3.013,95%CI值分别为1.211~4.323、1.872~6.214,P值分别为0.034、0.013。 结论 DAI患者认知功能障碍发病率高,主要表现在注意力、抽象思维、延迟记忆等方面的损害,年龄、昏迷时间是认知功能障碍的独立危险因素。 |
| 关 键 词： | 弥漫性轴索损伤 认知功能障碍 危险因素 |
| 收稿时间： | 2018-07-25 |
Clinical characteristics and relative factors of cognitive dysfunction in diffuse axonal injury |
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| Affiliation: | 1. Department of Neurology,the Second Affiliated Hospital of Jiaxing University,Jiaxing,Zhejiang 31400,China |
| Abstract: | Objective To investigate the clinical characteristics and related factors of cognitive impairment secondary to diffuse axonal injury(DAI) and provide clinical basis for early intervention. Methods Eighty-five patients with DAI conforming to the standard were included, and baseline information including demographic information, admission glasgow coma scale(GCS), coma time, operation,combination of other injuries, hypertension, diabetes, smoking, drinking, and nosocomial infection were collected. Montreal Cognitive Assessment(MoCA) was performed 3 months after injury to evaluate cognitive function in 85 patients with DAI. The analysis was done by t-test,χ2-test and logical regression analysis. Results Cognitive dysfunction occurred in 62 patients with DAI(72.9%). Cognitive dysfunction mainly manifested in attention, abstraction and memory(with t values respectively 9.004, 2.424, 7.423, P values below 0.001). logistic regression analysis showed that age and coma time were the risk factors for cognitive dysfunction(OR values respectively 1.842, 3.013, 95%CI values 1.211-4.323, 1.872-6.214, P values 0.034, 0.013). Conclusion Cognitive dysfunction in DAI mainly manifest in attention, abstraction and memory damage. Age and coma time are risk factors of cognitive dysfunction. |
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