CAJ | 학술논문

目的：探讨缺血性卒中后认知障碍的危险因素。方法共收集535例发病24h内入院的缺血性卒中患者，根据简易精神状态检查量表（MMSE）评分分为正常组（435例）和异常组（100例），对所有患者均在24h内进行MMSE评分、美国国立卫生研究院卒中量表（NIHSS）评分、脑CT和（或）磁共振成像检查，并完成血清尿酸、血糖、血脂、肝功能、肾功能、血常规等的测定，同时收集患者的基本信息。结果由按α＝0.05引入水准，进行逐步logistic回归分析可见，NIHSS评分、血小板（PLT）异常，低密度脂蛋白（LDL）异常，血尿酸异常，年龄＞60岁以上是影响患者MMSE评分异常的主要因素，尤其是PLT异常和NIHSS评分异常。患者年龄＞60岁是年龄≤60岁患者MMSE出现异常风险的2.196倍，血尿酸异常的患者出现MMSE异常的风险是正常范围内患者的1.600倍；PLT异常的患者出现MMSE异常的风险是血小板在正常范围内患者的7.397倍；NIHSS评分异常的患者出现MMSE异常的风险是NIHSS评分正常患者的2.860倍；LDL异常的患者出现MMSE异常的风险是LDL正常范围内患者的2.189倍。结论血尿酸异常、年龄偏大、NIHSS评分异常、PLT异常、LDL异常均与MMSE评分密切相关，血尿酸、NIHSS评分结果等因素可以作为早期预测患者发生缺血性卒中后认知障碍的重要因素，为临床较早地对卒中患者进行干预提供了很好的理论基础。
목적：탐토결혈성졸중후인지장애적위험인소。방법공수집535례발병24h내입원적결혈성졸중환자，근거간역정신상태검사량표（MMSE）평분분위정상조（435례）화이상조（100례），대소유환자균재24h내진행MMSE평분、미국국립위생연구원졸중량표（NIHSS）평분、뇌CT화（혹）자공진성상검사，병완성혈청뇨산、혈당、혈지、간공능、신공능、혈상규등적측정，동시수집환자적기본신식。결과유안α＝0.05인입수준，진행축보logistic회귀분석가견，NIHSS평분、혈소판（PLT）이상，저밀도지단백（LDL）이상，혈뇨산이상，년령＞60세이상시영향환자MMSE평분이상적주요인소，우기시PLT이상화NIHSS평분이상。환자년령＞60세시년령≤60세환자MMSE출현이상풍험적2.196배，혈뇨산이상적환자출현MMSE이상적풍험시정상범위내환자적1.600배；PLT이상적환자출현MMSE이상적풍험시혈소판재정상범위내환자적7.397배；NIHSS평분이상적환자출현MMSE이상적풍험시NIHSS평분정상환자적2.860배；LDL이상적환자출현MMSE이상적풍험시LDL정상범위내환자적2.189배。결론혈뇨산이상、년령편대、NIHSS평분이상、PLT이상、LDL이상균여MMSE평분밀절상관，혈뇨산、NIHSS평분결과등인소가이작위조기예측환자발생결혈성졸중후인지장애적중요인소，위림상교조지대졸중환자진행간예제공료흔호적이론기출。
Objective To investigate the risk factors of cognitive dysfunctions after ischemic stroke .Meth‐ods According to the mini‐mental state examination (MMSE) scores ,a total of 535 patients collected within 24 hours from onset of ischemic stroke were divided into 2 groups :normal group (435 cases) and abnormal group (100 cases) .In 24 h ,all patients underwent MMSE score ,NIHSS (national institutes of health stroke scale score) ,brain CT and/or MRI examination ,then took the determination of their serum uric acid ,blood glucose , blood lipid ,liver function ,renal function and routine blood test etc .Results Through the logistic regression anal‐ysis based onα= 0 .05 ,it was showed that NIHSS score ,platelet (PLT ) abnormality ,low‐density lipoprotein (LDL) abnormality and blood uric acid abnormality ,the age over 60 years old were the mainly effective factor ,for MMSE score ,particularly PLT and NIHSS score abnormalities appeared more obvious .The risk of MMSE abnor‐malities was 2 .196 times higher in those patients aged over 60 years old than that in the patients aged below 60 years old ,and the risk of MMSE abnormalities was 1 .600 times higher in those patients with blood uric acid ab‐normality than that in the patients whose blood uric acid were in normal range ;the risk of MMSE abnormalities was 7 .397 times higher in those patients with PLT abnormality than that in the patients whose PLT were in nor‐mal range;the risk of MMSE abnormalities was 2 .860 times higher in those patients with NIHSS score abnormali‐ties than that in the patients with NIHSS score normality ;the risk of MMSE abnormalities was 2 .189 times higher in those patients with LDL abnormality than that in the patients whose LDL were in normal range .Conclusion All these abnormalities such as serum uric acid abnormality ,age‐older ,NIHSS score abnormality ,PLT and LDL ab‐normalities were closely related with MMSE score ,blood uric acid ,NIHSS score and other factors which could be considered as main factors for early predicting the cognitive dysfunction after ischemic stroke .It could provide the‐oretical basis for early clinical intervention of stroke patients .