老年脑梗死后痴呆危险因素的临床研究

目的探讨老年脑梗死后痴呆的临床危险因素。方法选择于2002年10月~2004年10月入住天津港口医院的脑梗死患者共362例,其年龄≥60岁,男性192例,女性170例,包括其住院时及发病后2个月的病史、化验结果、神经病学、神经心理学等方面的临床资料,并进行统计学分析。结果入选362例患者中诊断为痴呆者102例(发生率为28.2%)。logistic回归分析显示高龄、低教育、脑卒中史、糖尿病、严重神经功能缺损、左半球脑梗死、前循环脑梗死等因素为脑梗死后痴呆的独立危险因素。结论老年脑梗死后约有1/4患者出现痴呆,其临床危险因素包括:梗死部位及严重程度、血管性危险因素(如糖尿病、脑卒中史)、患者的特征(如高龄、文化程度低)等。

Clinical study on the risk factors for dementia after brain infarction in old persons

Objective To investigate the clinical risk factors for dementia after brain infarction in old persons.Methods Data were taken from the hospitalized cases(over 60 years old) of brain infarction from October 2002 to October 2004,including data of medical history,laboratory examinations,neurology,neuropsychology,etc.of the patients on admission and two months after brain infarction.Statistical analysis was performed.Results A total of 362 patients were included.Dementia was diagnosed in 102 of 362 patients(28.2%).Logistic regression analysis indicated that old age,low level of education,prior stroke,diabetes,major brain infarction,left hemisphere infarction,infarction of anterior cerebral artery territories were independent risk factors for dementia after brain infarction.Conclusions Dementia after brain infarction occurred in one-fourth of the elderly patients.The clinical risk factors for dementia after ischemic stroke include the location and severity of brain infarction,vascular risk factors(such as diabetes,prior stroke),and host characteristics(such as old age,low level of education).