摘要
目的探讨代谢综合征与缺血性卒中后认知损害之间的关系。方法连续收集94例首发缺血性卒中患者的临床资料,分为非代谢综合征(非MetS)组和代谢综合征(MetS)组,对发病后2周和3个月时患者记忆力、执行功能、注意力、视空间等功能进行评价,参照Ballard等方法观察两组间认知功能演变的差异性。结果发病后2周和3个月时,94例患者认知损害发生率分别为24.47%(23/94)和22.34%(21/94),其中非痴呆性认知损害发生率分别为21.28%(20/94)和19.15%(18/94),痴呆性认知损害发生率均为3.19%(3/94、3/94)。MetS组患者发病2周和3个月时认知损害发生率分别为37.50%(15/40)和35.00%(14/40),与非MetS组之间差异有统计学意义(Z=2.500,P=0.012;Z=2.513,P=0.012);MMSE总评分,以及延迟回忆和画钟测验评分均低于非MetS组(P<0.05)。MetS组患者发病后3个月时认知功能进一步恶化的病例数高于非MetS组患者,差异有统计学意义(Z=2.134,P=0.033)。结论代谢综合征可增加缺血性卒中后认知损害发生率,以非痴呆性认知损害为主,主要累及执行功能、记忆力,其认知状态演变亦呈恶化趋势。
Objective To explore the relation between metabolic syndrome （MetS） and cognitive impairment after ischemic stroke. Methods Ninety four cases of first ischemic stroke patients were divided into stroke without MetS group （n = 54） and stroke with MetS group （n = 40） according to the diagnostic criteria for MetS defined by Metabolic Syndrome Researching Group of Chinese Diabetes Society. All patients underwent Mini Mental State Examination （MMSE）, Clock Drawing Test （CDT）, animal Verbal Fluency Test （aVFT）, Trial Making Test A （TMT A） at 2 weeks and 3 months after stroke to evaluate mental state such as verbal learning memory, and executive, attentional and visuospatial abilities. The incidence and development of cognitive impairment were also assessed. Results At 2 weeks and 3 months after stroke, the incidence of cognitive impairment were 24.47% （23/94） and 22.34% （21/94）, respectively, and in the cognitive impairment patients the incidence of non dementia were 21.28% （20/94） and 19.15% （18/94）, while the incidence of dementia were 3.19% （3/94） and 3.19% （3/94）, respectively. The incidence of cognitive impairment was higher in the stroke patients with MetS than the stroke patients without MetS, 37.50% （15/40） vs 14.81% （8/54） （Z = 2.500, P = 0.012） at 2 weeks after stroke and 35.00% （14/40） vs 12.96% （7/54） （Z = 2.513, P = 0.012） at 3 months after stroke. In the scores of MMSE, delay recall and CDT of the stroke patients with MetS were all lower than those without MetS at 2 weeks after stroke and at 3 months after stroke （P 0.05, for all）. The stroke patients with MetS had more cognition deterioration than the stroke patients without MetS at 3 months after stroke, the difference was significant （Z = 2.134, P = 0.033）. Conclusion MetS can increase the incidence of cognitive impairment, especially non dementia cognitive impairment in post ischemic stroke. Executive dysfunction and hypomnesis are often seen. The development of cognitive impairment in stroke patients with MetS tends to deterioration.
出处
《中国现代神经疾病杂志》
CAS
2012年第1期67-72,共6页
Chinese Journal of Contemporary Neurology and Neurosurgery
关键词
代谢疾病
脑缺血
痴呆
血管性
认知障碍
Metabolic diseases
Cerebral ischemia
Dementia
vascular
Cognitive disorders
