急性缺血性脑卒中后认知障碍患者精神行为症状的特征性分析

被引：64

作者：

孙胜楠 ^{[1
]}

徐耀 ^{[2
]}

马灿灿 ^{[2
]}

朱婷珂 ^{[1
]}

董珍 ^{[2
]}

胡月 ^{[3
]}

徐俊 ^{[4
]}

机构：

[1] 大连医科大学

[2] 江苏省苏北人民医院神经内科

[3] 张家港市第一人民医院神经内科

[4] 首都医科大学附属北京天坛医院神经病学中心认知障碍科国家神经系统疾病临床医学研究中心

来源：

中华老年心脑血管病杂志 | 2020年 / 22卷 / 04期

关键词：

卒中; 痴呆; 认知障碍; 精神障碍;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）]; R749 [精神病学];

学科分类号：

100204 [神经病学];

摘要：

目的探讨急性缺血性脑卒中后认知障碍(PSCI)患者精神行为症状(BPS)发生的特征。方法纳入2018年1月～2019年5月苏北人民医院神经内科住院的急性脑梗死患者105例,PSCI患者73例分为脑卒中后痴呆(PSD)组28例和脑卒中后认知障碍非痴呆(PSCI-ND)组45例,脑卒中后非认知障碍(非PSCI)组32例。PSCI患者又分为BPS组50例和非BPS组23例。根据英国牛津郡社区脑卒中规划分型,将急性脑梗死患者分为部分前循环梗死型(PACI)、后循环梗死型和腔隙性脑梗死型(LACI)。认知功能评估采用简易智能状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA),BPS评估采用神经精神问卷(NPI)。评价患者日常生活活动能力量表(ADL),并收集相关临床资料。结果 PSD组和PSCI-ND组NIHSS评分、NPI总分、BPS发生率均明显高于非PSCI组,教育年限明显低于非PSCI组(P<0.05)。PSD组年龄明显高于PSCI-ND组(P<0.05)。BPS组ADL总分、MMSE总分和MoCA总分明显低于非BPS组[(86.90±10.50)分vs(92.61±10.10)分,P=0.032;(24.39±2.13)分vs(20.36±4.27)分,P=0.000;(17.04±4.23)分vs(22.00±2.65)分,P=0.000]。与非BPS组比较,BPS组PACI发生率明显升高(52.0%vs 4.3%,P=0.000),LACI发生率明显降低(20.0%vs 56.5%,P=0.002)。PSD组和PSCI-ND组幻觉、激越、抑郁、淡漠、异常运动和睡眠行为障碍比例明显高于非PSCI组(P<0.05)。PSD组激越、抑郁、淡漠和睡眠行为障碍比例明显高于PSCI-ND组(P<0.05)。结论 PSCI患者较易出现BPS,其认知水平不同BPS发生率及表现不同,揭示了PSCI的临床异质性特点,为PSCI的治疗提供临床依据。

引用

页码：348 / 351

页数：4

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