国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2015年
4期
260-264
,共5页
周亚飞%石晶%司翠平%徐扬%闫中瑞
週亞飛%石晶%司翠平%徐颺%閆中瑞
주아비%석정%사취평%서양%염중서
卒中%脑缺血%认知障碍%动脉粥样硬化%危险因素
卒中%腦缺血%認知障礙%動脈粥樣硬化%危險因素
졸중%뇌결혈%인지장애%동맥죽양경화%위험인소
Stroke%Brain Ischemia%Cognition Disorders%Atherosclerosis%Risk Factors
目的 探讨急性缺血性卒中患者认知损害与脑动脉粥样硬化的相关性.方法 选择发病前无认知损害的急性缺血性卒中患者.采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评价认知功能,MRI确定梗死部位和侧别,磁共振血管造影、CT血管造影或数字减影血管造影确定粥样硬化动脉.结果 共纳入101例急性缺血性卒中患者,其中75例(74.3％)存在认知损害,认知损害组年龄[(54.54±12.59)岁对(64.43±10.37)岁;t=-3.960,P＜0.001]以及受教育年限≤6年(50.7％对11.5％;x2=12.257,P＜0.001)和脑动脉粥样硬化(89.3％对50.0％;x2=18.137,P＜0.001)患者构成比显著高于认知功能正常组.多变量logistic回归分析显示,脑动脉粥样硬化是急性缺血性卒中患者认知损害的独立危险因素(优势比1.720,95％可信区间1.005～2.942;P=0.048).MoCA评分与责任血管(r=-0.365,P＜0.001)和粥样硬化程度最重血管(r=-0.243,P=0.014)均呈显著负相关.结论 多数急性缺血性卒中患者在发病后早期即存在认知损害,且MoCA评分与脑动脉粥样硬化程度呈负相关,脑动脉粥样硬化是急性缺血性卒中患者认知损害的独立危险因素.
目的 探討急性缺血性卒中患者認知損害與腦動脈粥樣硬化的相關性.方法 選擇髮病前無認知損害的急性缺血性卒中患者.採用矇特利爾認知評估量錶(Montreal Cognitive Assessment,MoCA)評價認知功能,MRI確定梗死部位和側彆,磁共振血管造影、CT血管造影或數字減影血管造影確定粥樣硬化動脈.結果 共納入101例急性缺血性卒中患者,其中75例(74.3％)存在認知損害,認知損害組年齡[(54.54±12.59)歲對(64.43±10.37)歲;t=-3.960,P＜0.001]以及受教育年限≤6年(50.7％對11.5％;x2=12.257,P＜0.001)和腦動脈粥樣硬化(89.3％對50.0％;x2=18.137,P＜0.001)患者構成比顯著高于認知功能正常組.多變量logistic迴歸分析顯示,腦動脈粥樣硬化是急性缺血性卒中患者認知損害的獨立危險因素(優勢比1.720,95％可信區間1.005～2.942;P=0.048).MoCA評分與責任血管(r=-0.365,P＜0.001)和粥樣硬化程度最重血管(r=-0.243,P=0.014)均呈顯著負相關.結論 多數急性缺血性卒中患者在髮病後早期即存在認知損害,且MoCA評分與腦動脈粥樣硬化程度呈負相關,腦動脈粥樣硬化是急性缺血性卒中患者認知損害的獨立危險因素.
목적 탐토급성결혈성졸중환자인지손해여뇌동맥죽양경화적상관성.방법 선택발병전무인지손해적급성결혈성졸중환자.채용몽특리이인지평고량표(Montreal Cognitive Assessment,MoCA)평개인지공능,MRI학정경사부위화측별,자공진혈관조영、CT혈관조영혹수자감영혈관조영학정죽양경화동맥.결과 공납입101례급성결혈성졸중환자,기중75례(74.3％)존재인지손해,인지손해조년령[(54.54±12.59)세대(64.43±10.37)세;t=-3.960,P＜0.001]이급수교육년한≤6년(50.7％대11.5％;x2=12.257,P＜0.001)화뇌동맥죽양경화(89.3％대50.0％;x2=18.137,P＜0.001)환자구성비현저고우인지공능정상조.다변량logistic회귀분석현시,뇌동맥죽양경화시급성결혈성졸중환자인지손해적독립위험인소(우세비1.720,95％가신구간1.005～2.942;P=0.048).MoCA평분여책임혈관(r=-0.365,P＜0.001)화죽양경화정도최중혈관(r=-0.243,P=0.014)균정현저부상관.결론 다수급성결혈성졸중환자재발병후조기즉존재인지손해,차MoCA평분여뇌동맥죽양경화정도정부상관,뇌동맥죽양경화시급성결혈성졸중환자인지손해적독립위험인소.
Objective To investigate the correhtion between cognitive impairment and cerebral atherosclerosis in patients with acute ischemic stroke.Methods Acute ischemic stroke patients without cognitive impairment were recruited before symptom onset.The Montreal cognitive assessment (MoCA) was used to evaluate the cognitive function.Magnetic resonance imaging (MRI) was used to identify the infarct locations and sides.Magnetic resonance angiography,CT angiography and digital subtraction angiography were used to identify atherosclerotic arteries.Resul~ A total of 101 patients with acute ischemic stroke were enrolled,including 75 (74.3％) with cognitive impairment.The proportions of age (54.54 ± 12.59 years vs.64.43 ± 10.37 years;t =-3.960,P ＜0.001),years of education ≤6 years (50.7％ vs.11.5％;x2 =12.257,P ＜ 0.001),and cerebral atherosclerosis (89.3％ vs.50.0％;x2 =18.137,P ＜0.001) of the cognitive impairment group were significantly higher than those of the normal cognitive function group.Multivariate logistic regression analysis showed that cerebral atherosclerosis was an independent risk factor for cognitive impairment in patients with acute ischemic stroke (odds ratio 1.720,95％ confidence interval 1.005-2.942;P=0.048).MoCA score was negatively correlated with the offending vessels (r=-0.365,P＜ 0.001) and the most severe vessels of atherosclerotic degree (r=-0.243,P =0.014).Conclusions Most patients with acute ischemic stroke had cognitive impairment in the early stage after onset,and the MoCA scores was negatively correlated with the degree of cerebral atherosclerosis.Cerebral atherosclerosis was an independent risk factor for cognitive impairment in patientswith acute ischemic stroke.
