急性脑卒中后执行功能障碍的危险因素

目的:探讨急性脑卒中后执行功能障碍发生的危险因素.方法:连续搜集符合健康对照组入组标准者80人,应用Mattis痴呆量表的主动/持续部分(MDRS I/P)评估执行功能.计算MDRS I/P评分的均数和标准差,将均数±标准差*2作为MDRS I/P评分正常值的下限.连续搜集于我院住院治疗的符合入组标准的急性脑卒中患者,记录患者的一般资料,登记入院时NIHSS评分.根据入院后脑磁共振T2成像表现记录梗死灶部位.采用Mattis痴呆量表的主动/持续部分(MDRS I/P)对患者的执行功能进行评估,根据有无伴发执行功能障碍,将患者分为两组,比较两组间临床资料、病灶部位是否存在统计学差异.结果:健康对照组年龄为(65.7±8.9)岁,MDRS I/P评分(32.7±3.1)分.MDRS I/P评分≤26分被认为存在执行功能障碍.共有74例脑卒中患者入组,21例(29.3％)患者被认为存在执行功能障碍.脑卒中后执行功能障碍的患者男性比例明显低于无伴执行功能障碍的患者(42.9％ vs.69.8％,P=0.031),而存在脑血管病史的患者比例明显高于无伴执行功能障碍的患者(52.4％ vs.26.4％,P=0.033).左侧基底节区存在梗死灶的患者执行功能障碍的发生比例明显增高(P=0.008).结论:女性、脑血管病史和左侧基底节区梗死灶与急性脑卒中后执行功能障碍的发生有关.

Risk Factors for Post Stroke Executive Dysfunction

Objective To explore the risk factors for post stroke executive dysfunction in acute stroke patients.Methods Eighty healthy controls who met criteria for inclusion were recruited consecutively.Executive function was evaluated by Mattis Dementia Rating Scale initiation /perseverence subscale(MDRS I /P).The bottom of normal value was calculated by the formula.Acute stroke patients who were admitted in our hospital and met criteria for inclusion were included.The clinical characteristics(including NIHSS score) were recorded.MDRS I /P was evaluated two weeks after stroke onset.Brain lesions were recorded on brain MR-T2 sequence.The clinical characteristics and location of brain lesions were compared between patients with executive dysfunction and patients’ without.Results The bottom value for MDRS I /P was 27.Seventy-four stroke patients were included in this study.Twenty-one patients(29.3%) had executive dysfunction.The proportion of male was lower in stroke patients with executive dysfunction than those without(42.9% vs.69.8%,P = 0.031).More patients had history of cerebrovascular disease in the former than in the latter(52.4% vs.26.4%,P = 0.033).The incidence of executive dysfunction was higher in patients with lesions in left basal ganglia than those without(P = 0.008).Conclusion Female,history of cerebrovascular disease and left basal ganglia lesions were risk factors for post stroke executive dysfunction.