脑梗死后血管性认知功能障碍的危险因素研究

目的：探讨脑梗死后血管性认知功能障碍（ VCI）的危险因素。方法选择2011年我院收治的78例经中文版蒙特利尔量表（ MoCA）评定存在VCI的脑梗死患者作为VCI组，67例同期住院的不存在VCI的脑梗死患者作为对照组，比较两组患者的VCI相关影响因素，包括高龄（≥70岁）和低教育（≤6年）所占比例及高血压、糖尿病、冠心病、高同型半胱氨酸血症、高低密度脂蛋白血症、血管狭窄（＞50％）、左侧梗死、多次梗死、大面积梗死、脑白质疏松、吸烟、酗酒、脑萎缩发生率，并将脑梗死后VCI的相关影响因素进行多因素Logistic回归分析；比较两组患者MoCA各项评分及总分。结果单因素分析结果显示， VCI组患者高龄（≥70岁）、低教育（≤6年）所占比例及高血压、糖尿病、血管狭窄（＞50％）、左侧梗死、多次梗死、大面积梗死、脑白质疏松、酗酒、脑萎缩发生率均高于对照组（P＜0.05）。多因素Logistic回归分析结果显示，高龄（≥70岁）〔OR＝5.971，95％CI （0.750，0.902）〕、左侧梗死〔OR＝4.861，95％CI （1.244，9.779）〕、糖尿病〔OR＝3.563，95％CI （1.181，9.336）〕、血管狭窄（＞50％）〔OR＝3.013，95％CI （1.272，13.481）〕、大面积梗死〔OR＝10.063，95％CI （1.416，33.295）〕、脑白质疏松〔OR＝3.361，95％CI （1.580，16.339）〕、脑萎缩〔OR＝2.794，95％CI （1.518，16.593）〕、酗酒〔OR＝2.421，95％CI （2.403，55.444）〕及多次梗死〔OR＝4.538，95％CI （1.165，13.550）〕是脑梗死后VCI的危险因素（ P＜0.05）。两组患者语言流.能力、命名能力、抽象概括能力及定向能力评分比较，差异无统计学意义（ P＞0.05）； VCI组患者记忆能力、视空间执行能力、注意及计算能力评分及MoCA总分均低于对照组（ P＜0.05）。结论高龄（≥70岁）、左侧梗死、糖尿病、血管狭窄（＞50％）、

Risk Factors of Vascular Cognitive Impairment after Cerebral Infarction

Objective To investigate the risk factors of vascular cognitive impairment （ VCI） after cerebral infarction . Methods In 2011, 78 VCI patients after cerebral infarction diagnosed by MoCA （ Chinese version ） were selected as VCI group in our hospital , 67 cerebral infarction patients without VCI were selected as control group.The related influencing factors of VCI between the two groups were compared , including proportion of elderly （ 〉70 years） , low education level （ 〈6 years） and incidences of hypertension, diabetes, coronary disease, hyperhomocysteinemia, hyper-LDL-choleste rolemia, vascular ste-nosis （〉50%）, left infarction, multiple infarctions, large area infarction, leukoaraiosis, smoking, drinking and brain atro-phy, and then the related influencing factors were analyzed by multivariate Logistic regression analysis.MoCA scores between the two groups were compared too .Results Univariate analysis showed that , the proportion of elderly （〉70 years） , low educa-tion level （〈6 years） and the incidences of hypertension , diabetes, vascular stenosis （〉50%）, left infarction, multiple in-farctions, large area infarction, leukoaraiosis, drinking and brain atrophy of VCI group were higher than those of control group （P〈0.05） .Multivariate Logistic regression analysis showed that , elderly （ 〉70 years） 〔OR=5.971, 95%CI （0.750, 0.902）〕, left infarction 〔OR=4.861, 95%CI （1.244, 9.779）〕, diabetes 〔OR=3.563, 95%CI （1.181, 9.336）〕, vascular stenosis （ 〉50%） 〔OR =3.013, 95%CI （1.272, 13.481）〕, large area infarction 〔OR =10.063, 95%CI （1.416, 33.295）〕, leukoaraiosis 〔OR =3.361, 95%CI （ 1.580, 16.339 ）〕, brain atrophy 〔OR =2.794, 95%CI （1.518, 16.593）〕, drinking 〔OR=2.421, 95%CI （2.403, 55.444）〕 and multiple infarctions 〔OR=4.538, 95%CI （1.165, 13.550 ）〕 were the risk factors of VCI after cerebral infarction （P〈0.05） .There was no significant differences of scores of language fluency ,