卒中后认知功能障碍的转归及其影响因素

Outcome of post-stroke cognitive impairment and its risk factors

摘要:

卒中后认知功能损害是脑卒中常见的并发症, 其发病率为21.8%～50.0%。卒中后认知功能损害不仅影响患者的生存质量, 也给家庭和社会带来负担。但是在度过急性期后, 卒中后发生认知功能损害的患者也出现了不同的转归。年龄比较小、卒中前认知功能状态良好的患者相对容易出现认知功能的好转, 但是年龄偏大、卒中前认知状况差、文化程度低、血压控制偏低、脑白质变性程度较重、合并糖尿病的患者即使度过了卒中急性期仍易出现认知功能的进一步恶化。而性别, 卒中部位, 卒中常见的危险因素, 如高血压、高血脂、心脏病病史、饮酒史等, 对卒中后认知功能障碍的临床转归产生的影响有待于进一步证实。

Abstract:

Post-stroke cognitive impairment is common in stroke patients, with the incidence of 21.8%~50.0%. Post-stroke cognitive impairment can be burdensome to the involved individuals, as well as to their family members and the society as a whole. But after the acute stage, the patients have different outcome. The patients who are young and have good cognitive condition before stroke usually demonstrate improved cognition after acute stage; while the patients who are older and have poor cognitive condition before stroke, less education, lower blood pressure, severe myelinopathy and diabetes mellitus, usually had depraved cognition after acute stage. There are still some arguments about the effects of gender, stroke location and stroke risk factors including hypertension, hyperlipidemia, heart disease history and alcohol drinking history on the outcome of post-stroke cognitive impairment.