轻度血管性认知障碍影响因素分析 Influencing Factors of Mild Vascular Cognitive Impairment

Abstract

目的 探讨轻度血管性认知障碍（mild vascular cognitive impairment，mVCI）的影响因素。 方法 选取2015年8月-2018年10月收治于邯郸市第一医院神经内科的发病14 d内急性缺血性卒中 的患者为研究对象，行简易精神状态检查表、蒙特利尔认知评估量表测评，对其认知功能进行评估， 并根据其得分情况分为mVCI组及认知正常组。对比两组患者的临床资料的差异，采用单因素分析和 多因素Logistic回归分析探讨mVCI的影响因素。 结果 最终共纳入205例患者，mVCI组97例,认知正常组108例。①单因素分析显示，mVCI组患者低 文化程度（P =0.006）、高血压（P =0.032）、糖尿病（P =0.041）及吸烟（P =0.026）的比例显著高于 认知功能正常组，差异有统计学意义。mVCI组患者的血浆同型半胱氨酸水平（P =0.016）、TG水平 （P =0.040）、TC水平（P =0.026）以及匹兹堡睡眠质量指数（P＜0.001）显著高于认知正常组，差异有 统计学意义。②多因素Logistic回归分析显示，同型半胱氨酸水平升高（OR 1.139，95%CI 1.012～1.283， P =0.031）和主观睡眠质量差（OR 1.301，95%CI 1.107～1.530，P =0.001）是mVCI发生的独立危险因素， 而文化程度高（OR 0.652，95%CI 0.434～0.978，P =0.039）是mVCI 的保护性因素。 结论 高同型半胱氨酸血症及睡眠质量差是mVCI的独立危险因素，而文化程度高是mVCI的保护性因素。 Abstract: Objective To explore the influencing factors of mild vascular cognitive impairment (mVCI). Methods Patients with acute ischemic stroke within 14 days from onset who were admitted to Handan First Hospital From August 2015 to October 2018 were selected. All the patients were assessed by mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). According to the scores, these patients were divided into mVCI group and normal cognition (NCI) group. The clinical data were compared between the two groups, using univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors of mVCI. Results Finally, a total of 205 patients were included in this study, with 97 cases in mVCI group and 108 cases in NCI group. The proportion of patients with low education (P =0.006), hypertension (P =0.032), diabetes (P =0.041) and smoking (P =0.026) in mVCI group were significantly higher than that in NCI group. The levels of plasma homocysteine (P =0.016), triglyceride (P =0.040), cholesterol (P =0.026) and Pittsburgh sleep quality index (P <0.001) were significantly higher in mVCI group than that in NCI group. Elevated plasma homocysteine level (OR 1.139, 95%CI 1.012- 1.283, P =0.031) and multivariate logistic regression analysis showed that poor sleep quality (OR 1.301, 95%CI 1.107-1.530, P =0.001) were independent risk factors for mVCI, and high education degree (OR 0.652, 95%CI 0.434-0.978, P =0.039) was a protective factor. Conclusions Hyperhomocysteinemia and poor sleep quality are independent risk factors for mVCI, while high education degree is a protective factor for mVCI.

Keywords

• 轻度血管性认知障碍
• 危险因素
• 保护性因素
• mild vascular cognitive impairment
• risk factor
• protective factor