脑白质病变、颈动脉狭窄与非痴呆型血管性认知功能障碍患者预后的关系

Prognostic relationship between head and neck artery stenosis, white matter lesion and non-dementia vascular cognitive impairment

摘要:

目的 探讨脑白质病变（WML）、颈动脉狭窄（CAS）与非痴呆型血管性认知功能障碍（VCIND）患者预后的关系。方法 选取2015年1月—2018年1月江门市人民医院神经内科收治的VCIND患者158例，根据其治疗后6个月的预后情况，分成预后良好组与预后不良组。比较两组临床特征，包括性别、年龄、饮酒史、吸烟史、糖尿病、高血压、高脂血症、WML等级及ACS程度。利用Logistic回归模型分析预后不良的独立危险因素。结果 患者治疗后6个月入院复查，有125例预后良好，占79.11%，有33例预后不良，占20.89%。预后良好组的糖尿病、高血压、高脂血症、WML 3级、重度ACS占比分别为21.60%、19.20%、18.40%、4.00%和12.80%，低于预后不良组的54.55%、51.52%、45.45%、21.21%和45.46%，差异有统计学意义（P?< 0.05）。Logistic回归分析提示糖尿病、高血压、高脂血症、WML3级、重度CAS是患者预后不良的危险因素（P?< 0.05）。结论 除糖尿病、高血压、高脂血症外，VCIND患者的WML分级、CAS程度也是影响其预后的重要因素，临床需引起重视。

Abstract:

Objective To investigate the relationship between the prognosis of patients with head and neck artery stenosis (CAS), white matter lesion (WML) and vascular cognitive impairment of none dementia (VCIND). Methods A total of 158 patients with VCIND admitted to our hospital from January 2015 to January 2018 were selected. According to the prognosis of 6 months after treatment, the patients were divided into good prognosis group and poor prognosis group. The clinical characteristics of the two groups were compared, including gender, age, drinking history, smoking history, diabetes, hypertension, hyperlipidemia, WML grade and CAS level. Logistic regression model was used to analyze whether WML and CAS are independent risk factors for poor prognosis of patients. Results Six months after the treatment, 125 cases (79.11%) had good prognosis and 33 cases (20.89%) had poor prognosis. The proportions of diabetes mellitus, hypertension, hyperlipidemia, WML grade 3 and severe CAS were 21.60%, 19.20%, 18.40%, 4.00% and 12.80% in the group with good prognosis, which were lower than those in the group with poor prognosis, 54.55%, 51.52%, 45.45%, 21.21% and 45.45% respectively. The difference was significant (P?