中国卒中杂志2016，Vol.11Issue(4)：255-261,7.DOI:10.3969/j.issn.1673-5765.2016.04.004
急性缺血性卒中患者血管性认知障碍及其亚型的相关因素分析
Correlation Factors Analysis of Vascular Cognitive Impairment and Its Subtypes of Acute Ischemic Stroke Patients
摘要
Abstract
Objective To investigate the major correlation factors of vascular cognitive impairment (VCI) and its subtypes including VCI-no dementia (VCIND) and vascular dementia (VaD). <br> Methods A total of 491 patients with acute ischemic stroke admitted in Neurology Department of Tianjin Medical University General Hospital during June 2014 to June 2015 were recruited in this study. General demographic information, medical history, physical examination, vascular risk factors, laboratory and image data recorded in our previously established VCI database were used to assess. The National Institutes of Health Stroke Scale (NIHSS) scores, mechanism of ischemic stroke (the Trial of Org 10 172 in Acute Stroke Treatment, TOAST), Essen scores, Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), and Activities of Daily Living (ADL) after (10±2) days of stroke. Recruited patients were divided into VCI group and no cognitive impairment (NCI) group according to the Guide for Diagnosis and Treatment of VCI. Patients with VCI comprised of those with VCIND and VaD. Inter-group differences and correlations of factors mentioned above were analyzed. <br> Results Among 491 cases of patients with acute ischemic stroke, VCI accounted for 69.86% which was composed of 37.68% of VCIND and 32.18% of VaD. (1) Comparing to NCI group, patients with VCI were more likely to have higher low-educational status (P<0.001), diabetes (P=0.005), heart disease (P=0.045), family history of stroke (P=0.005), supratentorial stroke (P<0.001), stroke frequency (P=0.014), higher Essen scores (P=0.024), stroke severity (NIHSS) scores (P<0.001) and D-Dimer level (P=0.001), lower proportion of female (P=0.004) and subtentorial stroke (P<0.001), and less education year (P<0.001), which had significant differences. Logistic regression analysis showed that lower educational status, diabetes, supratentorial stroke, higher D-Dimer level were independent risk factors for VCI. (2) In VaD group, the proportion of prior stroke (P=0.013), TOAST subtype large artery atherosclerotic cerebral infarction (P<0.001) and stroke frequency (P=0.001), Essen scores (P=0.032), stroke severity (NIHSS) scores (P=0.005) were signiifcantly higher than those in VCIND group. Frequency of small-vessel occlusion (lacune) and infratentorial stroke (P<0.001) and proportation of subtentorial stroke (P<0.001) in VCIND were lower than VaD group, which had significant differences. Logistic regression analysis showed that stroke frequency, stroke severity (NIHSS) scores and large artery atherosclerotic cerebral infarction were independent risk factors for VaD. The risk of VaD in patients with infratentorial stroke was obviously lower than supratentorial stroke patients. <br> Conclusion Compared to NCI group, the inlfuential factors for VCI and its subtypes differ. Low educational status, diabetes, supratentorial stroke, higher D-Dimer level were independent risk factors for VCI. Compared to VCIND group, stroke frequency, stroke severity (NIHSS) scores and large artery atherosclerotic cerebral infarction were found to be the risk factors of VaD.关键词
血管性认知障碍/缺血性卒中/非痴呆性血管性认知障碍/血管性痴呆/危险因素Key words
Vascular cognitive impairment/Ischemic stroke/Vascular cognitive impairment-no dementia/Vascular dementia/Risk factors引用本文复制引用
曾瑞,李春芳,刘蕾,杜宁,张轩,陈书丽,薛蓉..急性缺血性卒中患者血管性认知障碍及其亚型的相关因素分析[J].中国卒中杂志,2016,11(4):255-261,7.基金项目
国家临床重点专科建设项目天津市卫生行业重点攻关项目（12KG132）天津市科技支撑项目资助 （）
