摘要
目的研究探讨老年人脑卒中后痴呆的相关危险因素。方法选取2012年6月—2013年10月住院治疗的急性脑卒中老年患者338例,均进行3个月的随访并做神经心理测试,采用Logistic回归法分析痴呆发生的相关危险因素。结果所有患者均完成随访,随访结束后338例脑卒中患者痴呆患者75例,占22.2%;痴呆组与非痴呆组相比,性别比较差异无统计学意义(χ2=0.002,P=0.967),非痴呆组的年龄明显低于痴呆组(t=20.021,P=0.000),痴呆组的低教育患者所占比例显著高于非痴呆组(χ2=65.085,P=0.000);痴呆组与非痴呆组在卒中史、糖尿病及饮酒者差异具有统计学意义(χ2=49.767、30.503、98.380,均P<0.05);痴呆组病灶左半球发生率及病灶多发发生率均高于非痴呆组(χ2=23.012、12.352,均P<0.05),且痴呆组NIHSS评分显著高于非痴呆组(t=7.451,P=0.000);在病灶直径>20 mm、脑萎缩及脑白质疏松方面,痴呆组与非痴呆组差异均具有统计学意义(χ2=47.794、37.130、11.295,均P<0.05);Logistic逐步回归分析结果显示筛选出年龄、饮酒、卒中病史、多灶病变、左侧病变、脑萎缩等为脑卒中后痴呆的危险因素。结论老年人脑卒中后痴呆的发病是由多种因素共同决定的,需提前干预以提高老年人生活质量。
Objective To study the risk factors of dementia after stroke in elder patients. Methods From June 2012 to October 2013,338 elderly inpatient with acute brain stroke in our hospital were selected ;3 months of follow-up was carried and neuropsychological tests were performed in all patients. Logistic regression was used to identify risk factors associated with the incidence of dementia. Results All patients were followed up for 3 months. Among 338 stroke patients, there were 75 cases of dementia（22.2% ）. Between the dementia group and non-dementia group, the male-female ratio was sim- ilar（ χ^2 = 0. 002, P = 0.967 ）. The age of patients in the non-dementia group was obviously lower than that in the dementia group （t = 20.021, P = 0. 000）. The low education patients in the dementia group were significantly more than that in the non-dementia group（ χ^2 = 65. 085 ,P = 0.000）. The proportion of patients with the history of stroke, diabetes and drinking was difference between the two groups（ χ^2= 49. 767, χ^2 = 30.503 and 98. 380, all P 〈 0.05 ）. The rate of left hemisphere brain damage and multiple lesions damage in the dementia group was higher than that in the non-dementia group χ^2 = 23. 012, 2 = 12. 352, all P 〈 0. 05 ）. NIHSS score in the dementia group was significantly higher than that in the non-de- mentia group（ t = 7.451 ,P = 0.0000 ）. There were significant differences in the diameter of lesions （ 〉 20 mm）, ratio of brain atrophy and leukoaraiosis between the dementia group and the non-dementia group （χ^2 = 47. 794, χ^2 = 37.130, X2 = 11. 295, all P 〈 0.05 ）. The results from Logistic regression analysis showed that the age, history of stroke and drinking, multiple lesions damage, left hemisphere brain damage and brain atrophy were the risk factors for dementia after stroke. Conclusion Many factors contribute to the onset of dementia after stroke, and the early interventions are necessary for improving the elderly patients＇ life quality.
出处
《中华全科医学》
2015年第4期596-598,共3页
Chinese Journal of General Practice
关键词
老年人
脑卒中
痴呆
相关因素
Stroke in the elderly
Dementia
Related factors
