【作者】 汪星；

【导师】 张蕲；

【作者基本信息】 华中科技大学 ， 神经病学， 2011， 硕士

【摘要】 目的调查湖北部分地区首发脑卒中后认知损害的发病率、危险因素和认知损害的特点。方法55例45岁以上的首发脑卒中患者入院时进行人口学特征、既往病史、实验室指标、卒中特点、影像学和NIHSS评估,卒中三个月后进行一系列神经心理学评估(主要针对记忆力、注意力、执行功能和视空间功能四个认知域),一个认知域受损被诊断为卒中后认知损害非痴呆(PSCIND),两个认知域受损及以上被诊断为卒中后痴呆(PSD);运用t检验、F检验、卡方检验和非参数检验对资料进行统计学分析。结果首发脑卒中后PSCIND的发病率为16.39%、PSD发病率为10.9%;与首发卒中后认知损害的危险因素有9个,分别是年龄(p<0.05)、教育水平(p<0.05)、额叶(p<0.05)、脑萎缩(p<0.05)、入院时腰围(p<0.05)和三个月后腰围(p<0.05)、入院时收缩压(p<0.05)和三个月后的收缩压(p<0.05)、三个月后抑郁存在(p<0.01);认知域损害特点:以记忆(5例)、执行功能(4例)和视空间功能障碍(9例)常见,注意功能一般不单独出现。结论1首发卒中后认知损害的发病率为27.29%,其中卒中后认知损害非痴呆发病率为16.39%、卒中后痴呆发病率为10.9%,临床医生应重视卒中后认知功能损害的筛查。2高龄、低教育水平、卒中后的抑郁存在、额叶受累、脑萎缩、入院时的高收缩压、卒中后三月的高收缩压、入院时的高腰围和卒中后三月的高腰围是卒中后认知障碍的危险因素。3首发脑卒中后认知障碍的受损认知域以视空间功能障碍、记忆力受损和执行功能障碍为常见,注意功能障碍一般不单独出现。更多还原

【Abstract】 purpose :to investigate prospectively the frequency、clinical determinants And the pattern of cognitive impairment in a cohort of consecutive first-ever stroke inpatients in parts of Hubei.Method:55 first-ever stroke survivors(>45 years of age) were evaluated at admission with a protocol( including demographic factors、health history、experimental examination、stroke-related factors、neuroimaging and NIHSS)and surveyed at 3 month after first-ever stroke with a detailed neuropsychological assessment (including memory、visuospatial、execution and attention ); PSCIND was diagnosed if one domain was impaired, PSD by two domain and more than two domain impaired.Result : 16.39% of subjects show poststroke cognitive impairment-no dementia 10.9% of subjects were defined as poststroke dementia ;the correlates of poststroke were education(p<0.05)、age(p<0.05)、cerebral atrophy(p<0.05)、frontal lobe (p<0.05)、systolic pressure at damission and three months ago(p<0.05)、waistline at damission and three months ago(p<0.05)depression(<0.01);the deficits in visuospation and memory were more pronounced in those with cognitive impairment at three month after first-ever stroke, and the deficit in attention is not lonely.Conclusions:1..the prevalence of poststroke cognitive impairment is 27.29%, including 16.39% of subjects diagnosed as PSCIND and 10.9% of subjects defined as PSD, the more attention should be paid to poststroke cognitive screening.2. the older、a low level of education、the depression after stroke、cerebral atrophy、the impaired frontal lobe、high level of systolic pressure at damission and three month ago、high level of waistline at damission and three month ago are identified as the risk factor leading to poststroke cognitive impairment.3. the deficits in visuospation、execution and memory were more pronounced in those with cognitive impairment at three month after first-ever stroke, and the deficit in attention is not lonely.更多还原