摘要
目的探讨短暂性脑缺血发作(TIA)患者认知功能障碍特点及危险因素。方法选取2019年2月至2022年9月成都医学院第二附属医院收治的143例TIA患者,采用蒙特利尔认知评估量表(MoCA)进行认知功能评估。根据是否出现认知功能障碍分为认知正常组和认知障碍组,对比两组认知功能特点、一般临床资料、血管狭窄及分布特征,分析TIA患者发生认知功能障碍的危险因素。结果所纳入的143例TIA患者中,46例存在认知功能障碍,发生率为32.17%。认知障碍组视空间与执行、命名、语言、延迟回忆、定向、计算力及MoCA总分均显著低于认知正常组(P<0.05)。认知障碍组受教育年限较认知正常组更短,血清高敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)及神经肽Y(NPY)水平则高于认知正常组(P<0.05)。认知障碍组颅内+颅外动脉均狭窄、责任血管狭窄≥50%比例大于认知正常组(P<0.05)。Logistic回归分析显示,受教育年限短、血清hs-CRP、Hcy及NPY水平升高、责任血管狭窄程度≥50%是TIA患者认知功能障碍的独立危险因素(P<0.05)。结论TIA患者认知功能损害涉及视空间与执行、命名、语言、延迟回忆、定向、计算力等多个认知域,受教育年限短、血清hs-CRP、Hcy及NPY水平升高、责任血管狭窄程度≥50%与TIA患者认知功能障碍的发生密切相关。
Objective To investigate the characteristics and risk factors of cognitive impairment in patients with transient ischemic attack(TIA).Methods 143 patients with TIA in the Second Affiliated Hospital of Chengdu Medical College from February 2019 to September 2022 were selected.Montreal Cognitive Assessment Scale(MoCA)was used to evaluate cognitive function.The patients were divided into cognitive normal group and cognitive impairment group according to the presence or absence of cognitive dysfunction.The characteristics of cognitive function,general clinical data,vascular stenosis and distribution characteristics were compared between the two groups.The risk factors of cognitive impairment in TIA patients were analyzed.Results Among 143 TIA patients included,46 cases had cognitive dysfunction,with the incidence was 32.17%.The scores of visuospatial and execution,naming,language,delayed recall,orientation,calculation and MoCA in the cognitive impairment group were significantly lower than those in the cognitive normal group(P<0.05).The years of education in the cognitive impairment group was shorter than that in the cognitive normal group(P<0.05),and the levels of high sensitive C-reactive protein(hs-CRP),homocysteine(Hcy),neuropeptide Y(NPY)were higher than those in the cognitive normal group(P<0.05).The proportion of both intracranial and extracranial artery stenosis,the proportion of offending vessel stenosis≥50%in the cognitive impairment group was significantly higher than that in the cognition normal group(P<0.05).Logistic regression analysis showed that short years of education,elevated serum levels of hs-CRP,Hcy and NPY,the degree of offending vessel stenosis≥50%were independent risk factors for cognitive impairment in TIA patients(P<0.05).Conclusions Cognitive impairment in patients with TIA involves multiple cognitive domains,such as visuospatial and execution,naming,language,delayed recall,orientation,calculation.Shorter education,higher levels of serum hs-CRP,Hcy and NPY,both intracranial and extracr
作者
曹秋菊
段海宇
李圆圆
Cao Qiuju;Duan Haiyu;LiYuanyuan(Department of Neurology,Second Afiliated Hospital of Chengdu Medical College,416 Hospital of Nuclear Industry,Sichuan 610000,China)
出处
《脑与神经疾病杂志》
CAS
2023年第12期732-736,共5页
Journal of Brain and Nervous Diseases
基金
四川省卫生健康科研课题立项项目(20PJ228)。
关键词
短暂性脑缺血发作
认知功能障碍
临床特点
危险因素
Transient ischemic attack
Cognitive impairment
Clinical characteristics
Risk factors
