脑缺血性卒中后认知障碍的临床特征及危险因素的多因素逻辑回归分析：对临床治疗的启示

Multivariate logistic regression analysis of clinical characteristics and risk factors of cognitive impairment after cerebral ischemic stroke: implications for clinical treatment.

作者信息

Ma Cuihong, Wang Dongjing, Li Xiaoqian, Feng Qiuju, Liu Yanmin, Hong Zengkun, Chen Lei

机构信息

Department of Neurology, Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.

Department of Neurology, Chengde Central Hospital, Chengde, China.

出版信息

Ann Transl Med. 2023 Jun 30;11(9):318. doi: 10.21037/atm-23-1043. Epub 2023 Jun 9.

DOI:10.21037/atm-23-1043

PMID:37405005

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10316089/

Abstract

BACKGROUND

Stroke ranks first among disease fatalities, and those who do survive stroke are prone to cognitive impairment. The aim of this study was to explore the clinical characteristics of post stroke cognitive impairment (PSCI) and the risk factors of PSCI using multivariate logistic regression.

METHODS

January 2018 to January 2021, the clinical data of 120 patients treated for cerebral ischemic stroke (CIS) at Chengde Central Hospital were retrospectively analyzed. In this study, patients were divided into 2 groups: a control group and a cognitive impairment group. The clinical characteristics of cognitive impairment following CIS were determined using multivariate logistic regression analysis to examine the risk factors and identify clinical implications.

RESULTS

This study included the assessment of overall cognitive function and daily living activities of 120 participants, 68 of whom experienced cognitive impairment, representing an incidence of 57%, while 43% patients represented no cognitive impairment after CIS. After the careful analysis of the data, there were remarkable differences in age, sex, education level, stroke history, infarction area, and infarction location (P<0.05). There was no remarkable difference in the history of hypertension, diabetes, atrial fibrillation, carotid intima thickness, smoking, or drinking (P>0.05). The degree of white matter degeneration, brain atrophy, and dominant hemisphere involvement was higher in the cognitive impairment group (P<0.05). The results of multivariate logistic regression analysis indicated that sex, age, education level, stroke history, infarction size, and infarction location were the main risk factors for cognitive impairment after CIS (P<0.05).

CONCLUSIONS

Patients with cognitive impairment after CIS have imaging features of white matter degeneration, brain atrophy, and involvement of dominant hemispheres. The results of multivariate logistic regression analysis indicated that sex, age, education level, stroke history, infarct size, and infarct location were main risk factors of cognitive impairment after CIS.

摘要

背景

中风在疾病致死率中排名第一，中风幸存者容易出现认知障碍。本研究旨在探讨中风后认知障碍（PSCI）的临床特征以及使用多因素逻辑回归分析PSCI的危险因素。

方法

回顾性分析2018年1月至2021年1月在承德市中心医院接受治疗的120例脑缺血性中风（CIS）患者的临床资料。在本研究中，患者被分为两组：对照组和认知障碍组。采用多因素逻辑回归分析确定CIS后认知障碍的临床特征，以检查危险因素并确定临床意义。

结果

本研究纳入了120名参与者的整体认知功能和日常生活活动评估，其中68人出现认知障碍，发生率为57%，而43%的患者在CIS后无认知障碍。经过对数据的仔细分析，年龄、性别、教育水平、中风史、梗死面积和梗死部位存在显著差异（P<0.05）。高血压、糖尿病、心房颤动、颈动脉内膜厚度、吸烟或饮酒史无显著差异（P>0.05）。认知障碍组的白质变性、脑萎缩程度和优势半球受累程度更高（P<0.05）。多因素逻辑回归分析结果表明，性别、年龄、教育水平、中风史、梗死大小和梗死部位是CIS后认知障碍的主要危险因素（P<0.05）。