目的:探讨初发脑卒中恢复期青年患者卒中后认知障碍(PSCI)的发生情况及其影响因素。
方法:共收集300例首次年轻卒中患者(年龄≤45岁)。使用简易精神状态检查(MMSE)评估认知状态。社会人口统计数据,临床症状,社会环境,收集和分析行为相关信息。
结果:青年卒中患者PSCI的发生率为62.33%。通过单变量分析,不同教育水平有统计学差异,吸烟状况与高血压的关系(P<0.05)。随后进行了多变量逻辑回归分析,结果发现,初中(OR=8.58,95CI:2.25~32.70)和高中(OR=10.50,95CI:2.69~41.00)的教育水平,病变体积>3.00cm3(OR=8.03,95CI:2.28~28.36),额-顶-颞区(OR=7.26,95CI:1.58~33.40)和基底节区(OR=6.13,95CI:1.24~30.43),NIHSS得分高(OR=1.17,95CI:1.06~1.29),高舒张压变异系数(OR=1.43,95CI:1.02~2.01)是PSCI的危险因素。同时,24≤BMI<28(OR=0.06,95CI:0.02~0.23)和BMI<24(OR=0.18,95CI:0.06~0.53),住院费用>20,000/月(OR=0.22,95CI:0.09~0.56),春、夏季卒中发病(OR=0.37,95CI:0.14~0.96)为保护因素。
结论:年轻卒中患者的PSCI发生率相对较高。初中和高中教育,中风病变>3.00cm3,额-顶-颞区和基底神经节区中风,NIHSS高分,高DBPV是年轻卒中患者PSCI的危险因素。同时,BMI<28,治疗费用>20,000/月,春夏季卒中发病是青年卒中患者PSCI的保护因素。
OBJECTIVE: To investigate the occurrence of post-stroke cognitive impairment (PSCI) and its influencing factors in convalescent young patients with first-ever stroke.
METHODS: A total of 300 first-ever young stroke patients (age ≤45 years) were collected. The Mini-Mental State Examination (MMSE) was used to assess the cognitive status. The sociodemographic data, clinical symptoms, social environment, and behavior-related information were collected and analyzed.
RESULTS: The incidence of PSCI in young stroke patients was 62.33 %. Through univariate analysis, there were statistical differences in different levels of education, smoking status and hypertension (P < 0.05). With subsequently multivariate logistic regression analysis, it was found that junior high school (OR=8.58,95 %CI:2.25∼32.70) and high school (OR=10.50,95 %CI:2.69∼41.00) education levels, lesion volume >3.00 cm3 (OR=8.03,95 %CI:2.28∼28.36), stroke in the frontal-parietal-temporal region (OR=7.26,95 %CI:1.58∼33.40) and the basal ganglia area (OR=6.13,95 %CI:1.24∼30.43), high NIHSS score (OR=1.17,95 %CI: 1.06∼1.29), and high diastolic blood pressure variability coefficient (OR=1.43,95 %CI: 1.02∼2.01) were risk factors for PSCI. Meanwhile, 24≤BMI<28 (OR=0.06,95 %CI:0.02∼0.23) and BMI<24 (OR=0.18,95 %CI:0.06∼0.53), hospitalization cost >20,000/month (OR=0.22,95 %CI:0.09∼0.56), and stroke onset in spring and summer (OR=0.37,95 %CI:0.14∼0.96) were protective factors.
CONCLUSIONS: The incidence of PSCI is relatively high in young stroke patients. Junior high and high school education, stroke lesions >3.00cm3, strokes in the frontal-parietal-temporal and basal ganglia regions, high NIHSS scores, and high DBPV are risk factors for PSCI in young stroke patients. Meanwhile, BMI<28, treatment cost >20,000/month, and stroke onset in spring and summer are protective factors for PSCI in young stroke patients.