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目的探讨脑梗死患者认知功能障碍的危险因素,以及病灶的部位与体积对认知功能的影响。方法选择脑梗死患者128例,分为认知功能障碍组62例,认知功能正常组66例,分析所有患者的病灶部位,同时检测蒙特利尔认知评估量表,分析年龄、文化程度、合并症等对认知功能的影响。结果脑梗死患者中,发生认知功能障碍者病灶多位于左侧半球,累及额叶、颞叶、丘脑的发生率明显高于未发生认知功能障碍者(P均<0.05);病灶位于顶叶、枕叶、脑干或小脑的发生率2组比较差异无统计学意义(P均>0.05)。年龄是否≥65岁及有无高血压病、2型糖尿病、高脂血症史与脑梗死后发生认知功能障碍的关联性有统计学意义(P均<0.05),受教育程度、2次以上卒中史、吸烟史与认知功能障碍的发生无明显关联(P均>0.05)。结论病灶位于左侧半球,累及额叶、颞叶皮质、丘脑,病灶体积较大者更易发生认知障碍,高龄、糖尿病、高血压、高血脂是脑梗死后发生认知功能障碍的危险因素。
Objective To investigate the risk factors of cognitive impairment in patients with cerebral infarction and the effect of lesion location and volume on cognitive function. Methods 128 patients with cerebral infarction were divided into cognitive dysfunction group (n = 62) and cognitive function group (n = 66). All the patients were analyzed for lesion site, Montreal Cognitive Assessment Scale and age, education level, comorbidity Such as the impact of cognitive function. Results Among the patients with cerebral infarction, most of the patients with cognitive impairment were found in the left hemisphere. The incidence of frontal lobe, temporal lobe, and thalamus were significantly higher than those without cognitive impairment (all P <0.05) The incidence of leaf, occipital lobe, brain stem or cerebellum was no significant difference between the two groups (P> 0.05). (P <0.05), education level, 2 times or not, age≥65 years and with or without hypertension, type 2 diabetes, history of hyperlipemia and cognitive dysfunction after cerebral infarction were statistically significant There was no significant correlation between the above stroke history, smoking history and the incidence of cognitive dysfunction (all P> 0.05). Conclusions The lesions are located in the left hemisphere, involving the frontal lobe, temporal cortex and thalamus. The lesions with larger volume are more likely to have cognitive impairment. Elderly patients with diabetes, hypertension and hyperlipidemia are the risk factors of cognitive impairment after cerebral infarction.