脑卒中后早期血管性认知功能障碍发生的危险因素分析

目的观察和分析缺血性脑卒中(IS)后早期血管性认知功能障碍(VCI)发生的危险因素。方法选取200例IS患者,根据是否在发病早期发生VCI将其分为VCI组(n=84)和非VCI组(n=116),根据是否在急性期出现应激高血糖将其分为应激性高血糖组(n=43)和非应激性高血糖组(n=66)。对所有纳入患者的年龄、性别、教育程度、饮酒、吸烟、高血压、血脂异常、冠心病、糖尿病、心房颤动、血浆同型半胱氨酸(Hcy)水平、血清超敏C反应蛋白(hs-CRP)水平及美国国立卫生研究院脑卒中量表(NIHSS)评分进行观察和分析。结果 VCI组患者与非VCI组患者在年龄、教育程度、饮酒、吸烟、高血压、血脂异常、冠心病、糖尿病、心房颤动、血浆Hcy水平、血清hs-CRP水平、NIHSS评分等方面的差异均有统计学意义(P<0.05);应激性高血糖组患者的NIHSS评分和VCI发生率均高于无应激性高血糖组,MoCA评分显著低于无应激性高血糖组(P<0.05);Logistic多元回归分析结果显示,IS后早期VCI的发生与糖尿病、高血压、血浆Hcy水平、血清hs-CRP水平均具有相关性(P<0.05)。结论 IS后早期发生VCI与糖尿病、高血压、血浆Hcy水平、血清hs-CRP水平有关。

Analysis in the risk factors of early vascular cognitive impairment after ischemic stroke

Objective To observe and analyze the risk factors of early vascular cognitive impairment (VCI) after ischemic stroke (IS).Methods A total of 200 IS patients were selected.The patients were divided into the VCI group (n=84) and the non VCI group (n=116) according to whether complicated with VCI in the early period, and they were also divided into the stress hyperglycemia group (n=43) and the non stress hyperglycemia group (n=66) according to whether complicated with stress hyperglycemia in acute period.The age, the gender, the education level, the smoking history, the drinking history, the hypertension condition, the dyslipidemia condition, the diabetes condition, the coronary heart disease condition, the atrial fibrillation condition, the plasma homocysteine (Hcy) level, the serum high sensitive C reactive protein (hs-CRP) level and the National Institute of Health stroke scale (NIHSS) score of the all the patients were observed and analysis.Results There were significant differences in the gender, the education level, the smoking history, the drinking history, the hypertension condition, the dyslipidemia condition, the diabetes condition, the coronary heart disease condition, the atrial fibrillation condition, the plasma Hcy level, the serum hs-CRP level and the NIHSS score between the VCI group and the non VCI group (P<0.05).The NIHSS score and the incidence rate of VCI in the patients in the stress hyperglycemia group were significantly higher than those in the non stress hyperglycemia group, and the MoCA score was significantly lower than that in the non stress hyperglycemia group (P<0.05).Logistic regression analysis results showed the incidence of VCI in the early period of IS was correlated with diabetes, the hypertension, the plasma Hcy level and the serum hs-CRP level (P<0.05).Conclusion The incidence of VCI in the early period of IS is correlated with diabetes, the hypertension, the plasma Hcy level and the serum hs-CRP level.