腔隙性脑梗死与认知功能障碍的相关影响因素分析

目的研究腔隙性脑梗死与认知功能障碍发生的时程关系及影响因素。方法回顾性分析134例腔隙性脑梗死患者资料,采用多元线性回归模型分析腔隙性脑梗死至认知功能障碍发生时间间隔及相关影响因素。结果腔隙性脑梗死病程范围2～15(4.42±1.24)年,中位数4年。与未合并高血压、糖尿病和血脂异常患者比较,合并高血压、糖尿病和血脂异常患者腔隙性脑梗死后至发生认知功能障碍的时程明显缩短,差异有统计学意义(P0.05,P0.01)。患者接受正规治疗较未接受正规治疗明显延长认知功能障碍时程(P0.01)。年龄增长、糖尿病、高血压可以使腔隙性脑梗死后发生认知功能障碍时程缩短;经正规治疗腔隙性脑梗死较未接受正规治疗者发生认知功能障碍时程延长。结论高血压、血脂异常和糖尿病患者发生腔隙性脑梗死后,导致认知功能障碍发生的过程中具有累积效应,有效治疗腔隙性脑梗死能够延迟认知功能障碍的发生。

Lacunar infarction and analysis of related influential factors of cognitive impairment

Objective To study the length of lacunar infarction history and its related factors in patients with cognitive impairment and lacunar infarction.Methods The data of 134 lacunar infarction patients were analyzed retrospectively.Lacunar infarction history meant the time interval between onset of first symptom of cognitive impairment and establishment of diagnosis of lacunar infarction.The related factors' influence on the length of lacunar infarction history was analyzed by means of multivariate linear regression model.Results 134 cognitive impairment patients' age were between 64 and 88 years.In cognitive impairment patients with lacunar infarction,the mean length of lacunar infarction history was 2 — 15(4.42 ± 1.24) years,with median length of 4 years. In multivariate linear regression model,increase in age when lacunar infarction was diagnosed,hypertension, diabetes mellitus and hyperlipoidemia were independent factors that shortened lacunar infarction history.Lacunar infarction treatment independently lengthened lacunar infarction history. Conclusion Coexisting diabetes mellitus and hypertension hasten while lacunar infarction treatment postpones onset of cognitive impairment in patients with lacunar infarction.