缺血性卒中患者认知与记忆障碍特征研究
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摘要
目的探讨缺血性卒中患者在认知与记忆障碍方面的特征。方法选取2014年1月至2016年12月收治的112例缺血性卒中患者为研究对象,其中40例无脑血管病变但有认知与记忆障碍的缺血性卒中患者作为A组,40例有脑血管病变且有认知与记忆障碍的缺血性卒中患者作为B组,32例既无脑血管病变且无认知与记忆障碍的患者作为C组,比较3组患者年龄、性别、受教育年限、高血压比例的差异,比较3组患者血清胰岛素样生长因子(IGF-1)、β-淀粉样蛋白1-42(Aβ1-42)以及视锥蛋白样蛋白-1(VILIP-1)水平,比较3组患者MoCA量表中视空间执行功能、注意、语言、抽象、延迟记忆、命名及定向的评分,对3组患者比较差异具有统计学意义的数据进行Logistic多因素回归分析,研究缺血性卒中患者认知与记忆障碍发生的危险因素。结果 3组患者年龄和高血压比例B组>A组>C组,受教育年限C组>A组>B组,差异均有统计学意义(P<0.05);3组患者性别比例差异无统计学意义(P>0.05);3组患者血清IGF-1、Aβ1-42水平C组>A组>B组,VILIP-1水平B组>A组>C组,差异均有统计学意义(P<0.05);3组患者MoCA量表评分比较发现,视空间执行功能、注意、语言、抽象、延时记忆评分C组>A组>B组,差异有统计学意义(P<0.05),命名与定向评分差异无统计学意义(P>0.05)。对3组患者比较差异有统计学意义的数据进行Logistic多因素回归分析,分析结果显示高龄、受教育年限低、高血压、低IGF-1水平、低Aβ1-42水平、高VILIP-1水平是缺血性卒中患者认知与功能障碍以及脑血管病变的危险因素。结论缺血性卒中认知与记忆障碍和脑血病病变具有相关性,其中高龄、受教育年限低、高血压、低IGF-1水平、低Aβ1-42水平、高VILIP-1水平是缺血性卒中患者认知与功能障碍以及脑血管病变的危险因素。
Objective To explore the characteristics of cognitive and memory disorders in the patients with ischemic stroke.Methods One hundred and twelve patients with ischemic stroke admitted to our hospital from January 2014 to December 2016 were selected as the research subjects.Among them,40 cases of ischemic stroke without cerebrovascular disease but with cognitive and memory impairment served as the group A,40 cases of ischemic stroke with cerebrovascular disease,and cognitive and memory impairment served as the group B,and 32 cases without cerebral vascular disease,and cognitive and memory impairment as the group C.The differences of age,gender,educational years and hypertension proportion were compared among the three groups,the levels of IGF-1,Aβ1-42 and VILIP-1were compared among the three groups and the scores of visuospatial executive function,attention,language,abstraction,delayed memory,naming and orientation in MoCA were compared among the three groups.The data with statistical significance in the comparison of difference among 3groups were performed the Logistical multivariate regression analysis.Then the risk factors of cognitive and memory impairment occurrence in the patients with ischemic stroke were studied.Results The age and hypertension proportion in 3groups:group B>group A>group C,the educational years:group C >group A>group B,the differences were statistically significant(P<0.05);the sex ratio had no statistical difference among 3groups(P>0.05);the serum IGF-1and Aβ1-42levels:the group C>group A>group B,the VILIP level:group B>group A>group C,the differences were statistically significant(P<0.05);the comparison of MoCA scores among 3groups found that the scores of visuospatial executive function,attention,language,abstraction and delayed memory:the group C >group A>group B,the difference were statistically significant(P<0.05),naming and orientation scores had no statistical difference(P>0.05).The Logistical multivariate regression analysis was performed on the data with statistical significance in 3groups comparison,the analytical results indicated that the advanced age,low educational years,hypertension,low IGF-1level,low Aβ1-42 level and high VILIP-1level were the risk factors of cognitive and memory function,and cerebralvascular diases in the patients with ischemic stroke.Conclusion Ischemic stroke has correlation with cognitive and memory disorders and cerebral blood disease,in which the advanced age,low educational years,hypertension,low IGF-1level,low Aβ1-42 level and high VILIP-1level are the risk factors of cognitive and memory function,and cerebralvascular disease in the patients with ischemic stroke.
Objective To explore the characteristics of cognitive and memory disorders in the patients with ischemic stroke.Methods One hundred and twelve patients with ischemic stroke admitted to our hospital from January 2014 to December 2016 were selected as the research subjects.Among them,40 cases of ischemic stroke without cerebrovascular disease but with cognitive and memory impairment served as the group A,40 cases of ischemic stroke with cerebrovascular disease,and cognitive and memory impairment served as the group B,and 32 cases without cerebral vascular disease,and cognitive and memory impairment as the group C.The differences of age,gender,educational years and hypertension proportion were compared among the three groups,the levels of IGF-1,Aβ1-42 and VILIP-1were compared among the three groups and the scores of visuospatial executive function,attention,language,abstraction,delayed memory,naming and orientation in MoCA were compared among the three groups.The data with statistical significance in the comparison of difference among 3groups were performed the Logistical multivariate regression analysis.Then the risk factors of cognitive and memory impairment occurrence in the patients with ischemic stroke were studied.Results The age and hypertension proportion in 3groups:group B>group A>group C,the educational years:group C >group A>group B,the differences were statistically significant(P<0.05);the sex ratio had no statistical difference among 3groups(P>0.05);the serum IGF-1and Aβ1-42levels:the group C>group A>group B,the VILIP level:group B>group A>group C,the differences were statistically significant(P<0.05);the comparison of MoCA scores among 3groups found that the scores of visuospatial executive function,attention,language,abstraction and delayed memory:the group C >group A>group B,the difference were statistically significant(P<0.05),naming and orientation scores had no statistical difference(P>0.05).The Logistical multivariate regression analysis was performed on the data with statistical significance in 3groups comparison,the analytical results indicated that the advanced age,low educational years,hypertension,low IGF-1level,low Aβ1-42 level and high VILIP-1level were the risk factors of cognitive and memory function,and cerebralvascular diases in the patients with ischemic stroke.Conclusion Ischemic stroke has correlation with cognitive and memory disorders and cerebral blood disease,in which the advanced age,low educational years,hypertension,low IGF-1level,low Aβ1-42 level and high VILIP-1level are the risk factors of cognitive and memory function,and cerebralvascular disease in the patients with ischemic stroke.
引文
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[11]任洪磊,张楠,孙庆娜,等.遗忘型轻度认知障碍与非痴呆性血管性认知障碍的认知损害及睡眠障碍特点[J].中华老年心脑血管病杂志,2015,16(3):231-234.
[12]张一,姚秋近,陈超,等.蒙特利尔认知评估量表对简易精神状态量表得分正常的颅脑创伤患者的认知功能评价[J].中华创伤杂志,2015,31(7):604-607.
[13]汤海艳,王军,魏其林,等.MoCA和MMSE评估老年帕金森病患者认知障碍的分析[J].中风与神经疾病杂志,2013,30(8):719-723.
[2]周楷,王群.急性缺血性脑卒中记忆障碍特点的研究[J].重庆医学,2013,42(12):1338-1339.
[3]谭泽锋,徐安定.2010年第七届世界卒中大会会议纪要[J].中华内科杂志,2011,50(3):262-263.
[4]张卫清,石进,张英谦,等.中青年缺血性卒中脑动脉狭窄分布及危险因素分析[J].临床神经病学杂志,2016,29(1):23-26.
[5]区腾飞,潘速跃,杨洁,等.缺血性小卒中复发及复发大卒中的危险因素分析[J].实用医学杂志,2014,42(11):1786-1788.
[6]王勇杰,张建民.药物相关性卒中及其防治策略[J].浙江大学学报(医学版),2015,57(4):361-365.
[7]付娜娜,袁薇,石正洪,等.缺血性卒中患者中国缺血性卒中亚型与临床短期预后的关系研究[J].中国全科医学,2013,16(25):2951-2953.
[8]王芳,邵剑波,张文涵,等.3D ASL成像在儿童脑血管病变诊断中的应用价值[J].放射学实践,2015,30(12):1177-1181.
[9]王兆鹏,李军,王淼,等.糖调节受损伴良性前列腺增生患者血清IGF-1、IGFBP-3的水平[J].实用医学杂志,2016,32(4):569-572.
[10]刘晓丽,张秀芝,孙长义,等.VILIP-1和NR2多肽联合检测在早期缺血性脑卒中的临床诊断价值[J].中华检验医学杂志,2014,36(6):469-472.
[11]任洪磊,张楠,孙庆娜,等.遗忘型轻度认知障碍与非痴呆性血管性认知障碍的认知损害及睡眠障碍特点[J].中华老年心脑血管病杂志,2015,16(3):231-234.
[12]张一,姚秋近,陈超,等.蒙特利尔认知评估量表对简易精神状态量表得分正常的颅脑创伤患者的认知功能评价[J].中华创伤杂志,2015,31(7):604-607.
[13]汤海艳,王军,魏其林,等.MoCA和MMSE评估老年帕金森病患者认知障碍的分析[J].中风与神经疾病杂志,2013,30(8):719-723.