Predictors for vascular cognitive impairment in stroke patients.
Predictors for vascular cognitive impairment in stroke patients.
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中风患者血管性认知障碍的预测因素
DOI：
10.1186/s12883-016-0638-8
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发表时间：
2016-07-26
期刊：
影响因子：
2.6
通讯作者：
Liu X
中科院分区：
文献类型：
--
作者：
Chen X;Duan L;Han Y;Tian L;Dai Q;Wang S;Lin Y;Xiong Y;Liu X
大约三分之二的中风患者可能患有血管性认知障碍（VCI）。我们的前期研究验证了NINDS-CSN统一标准在中国VCI诊断中的有效性。在这项研究中，我们的目的是探讨中国卒中后患者VCI的预测因素。我们比较了有和没有VCI的卒中患者的流行病学、临床和神经影像学资料（急性梗死和腔隙的数量、大小和位置，白色高信号和脑萎缩的严重程度）。单变量和逻辑回归分析用于确定VCI预测因子。五十六例连续患者（年龄，63.8 ± 8.3岁;女性，37.5%）在卒中发作后平均间隔7.1个月招募，31例（55.4%）患者根据经验证的60分钟神经心理成套测验诊断为VCI。VCI患者年龄较大（p = 0.023），受教育程度较低（p = 0.001），更可能是女性（p < 0.001），有复发性卒中（p = 0.028），与认知正常的患者相比，描述了更高的冷漠（p = 0.022）和更差的卒中前认知（p = 0.048）。文化程度较低（校正比值比[OR] 0.750，95%置信区间[CI]，0.573-0.981; p = 0.035），女性（校正OR 8.288，95%CI 1.522-45.113; p = 0.014），复发性卒中（校正OR 11.327，95% CI，1.335-96.130，p = 0.026），和整体皮质萎缩（调整OR 5.730，95% CI，1.128-29.101，p = 0.035）与卒中后患者的VCI独立相关。在中国脑卒中患者中，文化程度低、女性、复发性脑卒中和全脑皮质萎缩与VCI相关。本文的在线版本（doi：10.1186/s12883-016-0638-8）包含补充材料，可供授权用户使用。
Around two thirds stroke patients may suffer from vascular cognitive impairment (VCI). Our previous study has validated the NINDS-CSN harmonization standard for VCI diagnosis in Chinese. In this study, we aimed to investigate the predictors for VCI in Chinese post-stroke patients. We compared epidemiological, clinical, and neuroimaging data (number, size and location of acute infarcts and lacunes, severities of white matter hyperintensities and brain atrophy) between stroke patients with and without VCI. Univariate and logistic regression analyses were utilized to determine VCI predictors. Fifty-six consecutive patients (age, 63.8 ± 8.3 years; female, 37.5 %) were recruited at a mean interval of 7.1 months after stroke onset, and 31 (55.4 %) patients were diagnosed with VCI based on a validated 60-min neuropsychological battery. VCI patients were older (p = 0.023), less educated (p = 0.001), more likely to be female (p < 0.001), had a recurrent stroke (p = 0.028), and described higher apathy (p = 0.022) and worse pre-stroke cognition (p = 0.048) than cognitively normal patients. Lower educational level (adjusted odds ratio [OR] 0.750, 95 % confidence interval [CI], 0.573–0.981; p = 0.035), female sex (adjusted OR 8.288, 95 % CI, 1.522–45.113; p = 0.014), recurrent stroke (adjusted OR 11.327, 95 % CI, 1.335–96.130, p = 0.026), and global cortical atrophy (adjusted OR 5.730, 95 % CI, 1.128–29.101, p = 0.035) were independently associated with VCI in post-stroke patients. Lower education, female sex, recurrent stroke and global cortical atrophy were associated with VCI in Chinese stroke patients. The online version of this article (doi:10.1186/s12883-016-0638-8) contains supplementary material, which is available to authorized users.