老年缺血性脑卒中患者营养状况与卒中后认知功能障碍的关系
| 作者: |
1周菲,
1范天伦,
2陈秀红,
1周忠东,
1王雪娇
1 海南医学院第一附属医院康复医学科，海口 570120 2 海南省干部疗养院体检中心，海口 571100 |
| 通讯: |
王雪娇
Email: 442003412@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.03.022 |
摘要
目的：探讨老年缺血性脑卒中患者营养状况与卒中后认知障碍(post-stroke cognitive impairment，PSCI)的内在关系。方法：连续选入2019年5月至2021年2月在海南医学院第一附属医院住院治疗的92例老年缺血性脑卒中患者，采用微型营养评估(Mini Nutrition Assessment，MNA)量表评价营养状况。发病3个月后采用简易智力状态检查(Mini-Mental State Examination，MMSE)量表评估认知功能，分为PSCI组(MMSE≤26分)和正常组(MMSE>26分)。比较两组临床资料、MNA评分和营养不良发生率，Pearson相关分析法分析MNA评分与MMSE评分的相关性，多因素logistic回归分析老年缺血性脑卒中患者发生PSCI的危险因素。结果：PSCI发生率为35.87%(33/92)。PSCI组年龄、高血压患病率高于正常组，MNA评分低于正常组，差异均有统计学意义(均P<0.05)。营养不良发生率为28.26%(26/92)，MNA<17、MNA≥17患者的PSCI发生率分别为57.69%(15/26)、27.27%(18/66)，差异均有统计学意义(均P<0.05)。MNA评分与MMSE评分呈正相关(r=0.723，P<0.05)。多因素logistic回归分析显示：年龄[优势比(odds ratio，OR)=2.558，95%置信区间(confidence interval，CI)：1.123~5.812]、高血压(OR=2.317，95%CI：1.068~4.253)和MNA评分(OR=3.812，95%CI：1.294~5.796)均是老年缺血性脑卒中患者发生PSCI的独立影响因素(P<0.05)。结论：老年缺血性脑卒中患者的营养状况与MMSE评分紧密相关，营养不良是PSCI发生的危险因素。
关键词：
缺血性脑卒中；老年；营养状况；认知障碍；危险因素
Relationship between nutritional status and post-stroke cognitive dysfunction in elderly patients with ischemic stroke
CorrespondingAuthor: WANG Xuejiao Email: 442003412@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.03.022
Abstract
Objective: To investigate the relationship between nutritional status and post-stroke cognitive impairment (PSCI) in elderly patients with ischemic stroke. Methods: A total of 92 elderly patients with ischemic stroke who were hospitalized in the First Affiliated Hospital of Hainan Medical College from May 2019 to February 2021 were selected. The nutritional status was evaluated by Mini Nutrition Assessment (MNA) Scale. Three months after onset, Mini-Mental State Examination (MMSE) Scale was used to assess cognitive function. The patients were divided into a PSCI group (MMSE ≤26) and a normal group (MMSE >26). The clinical data, MNA score, and incidence of malnutrition were compared between the 2 groups. Pearson correlation analysis was used to analyze the correlation between MNA score and MMSE score. Multivariate logistic regression analysis was used to analyze the risk factors of PSCI in elderly patients with ischemic stroke. Results: The incidence of PSCI was 35.87% (33/92). The age and prevalence of hypertension in the PSCI group were higher than those in the normal group, and the MNA score was lower than that in the normal group (all P<0.05). The incidence of malnutrition was 28.26% (26/92). The incidence of PSCI in patients with MNA <17 and MNA ≥17 was 57.69% (15/26) and 27.27% (18/66), respectively, with significant difference (all P<0.05). MNA score was positively correlated with MMSE score (r=0.723, P<0.05). Univariate logistic regression analysis showed that age (OR=2.558, 95%CI: 1.123 to 5.812), hypertension (OR=2.317, 95%CI: 1.068 to 4.253), and MNA score (OR=3.812, 95%CI: 1.294 to 5.796) were independent influencing factors of PSCI in elderly patients with ischemic stroke (P<0.05). Conclusion: The nutritional status of elderly patients with ischemic stroke is closely related to MMSE score, and malnutrition is a risk factor of PSCI.
Keywords：
ischemic stroke; elderly; nutritional status; cognitive impairment; risk factors