腔隙性梗死患者血管性认知障碍危险因素的 Logistic 回归分析

Logistic regression analysis on the risk factors of vascular cognitive impairment with lacunar infarct

摘要:

目的 收集腔隙性梗死患者临床资料，分析其血管性认知障碍（VCI）的危险因素。方法 选 取2016 年5 月—2017 年2 月赤峰学院附属医院收治的156 例腔隙性脑梗死患者的临床和实验室资料，应用 美国国立卫生研究院卒中量表和蒙特利尔认知评价量表（MoCA）对患者神经功能及认知障碍进行评价， 结合患者临床资料及实验室血浆同型半胱氨酸浓度对认知障碍的危险因素进行多因素的Logistic 回归分析。 结果 62.18% 腔隙性脑梗死患者发生不同程度的VCI。多因素Logistic 回归分析结果显示，关键部位梗死 灶[Ol ^ R=5.937（95% CI ：1.086，32.458），P =0.040]、脑白质高信号[Ol ^ R=5.948（95% CI ：1.234，28.672）， P =0.026] 和血浆同型半胱氨酸浓度（Hcy）[Ol ^ R=4.389（95% CI ：1.039，18.535），P =0.044] 是腔隙性梗 死患者出现血管性认知损害的影响因素。血浆Hcy 浓度与MoCA 评分呈负相关（r =-0.694，P =0.000）。 结论 关键部位梗死灶、脑白质高信号和血浆同型半胱氨酸浓度是影响腔隙性梗死患者发生血管性认知损害 的主要危险因素。

Abstract:

Objective To collect clinical data of lacunar infarction patients, and to study the risk factors for vascular cognitive impairment (VCI) after lacunar infarct. Methods Collected clinical and laboratory data of 156 lacunar infarction patients, apply National Institute of Health stroke scale (NIHSS) and the Montreal cognitive assessment scale (MoCA) to evaluate neurological function and cognitive impairment. Multivariate Logistic regression analysis was used to screen the risk factors for VCI after lacunar infarction among the clinical data and blood plasma homocysteine concentration. Results 62.18% of patients occurred VCI. Multivariate Logistic regression analysis showed that infarct in critica (Ol ^ R=5.937, 95% CI=1.086, 32.458), white matter hyperintensity (WMH) (Ol ^ R=5.948, 95% CI=1.234, 28.672) and blood plasma homocysteine concentration (Ol ^ R=4.389, 95% CI=1.039, 18.535) were independent risk factors for VCI in patients with lacunar infarct (P < 0.05). In addition, MoCA score and blood plasma Hcy concentration was negative correlated negatively (r = -0.694, P < 0.05). Conclusions Infarct in critica, white matter hyperintensity (WMH) and blood plasma homocysteine concentration were independent risk factors for VCI in patients with lacunar infarct.