Risk factors for cognitive impairment in patients with acute cerebral infarction due to small artery occlusion

doi:10.3877/cma.j.issn.1674-0785.2020.03.005

Abstract

Abstract:

Objective

To identify the risk factors for mild cognitive impairment in patients with acute cerebral infarction caused by small artery occlusion in Lhasa, a plateau region.

Methods

From January 2016 to December 2019, 126 patients with acute cerebral infarction caused by small artery occlusion were enrolled at Tibet Autonomous Region People’s Hospital. Clinical data, imaging data, laboratory results, and neuropsychological scores were recorded. According to the evaluation results using the Montreal Cognitve Assessment scale, the patients were divided into a cognitive impairment group (Group 1; n=48) and a normal cognitive function group (Group 2; n=48).

Results

There was no significant difference between the two groups in age, gender, proportion of Tibetan patients, education level, hypertension, hyperlipidemia, coronary heart disease, HCY, or uric acid. The proportion of patients with diabetes mellitus in Group 1 was significantly higher than that in Group 2 (31.25% vs 14.10%, χ²=5.335, P=0.021). The proportion of patients with high altitude polycythemia in Group 1 was 22.92%, and that in Group 2 was only 8.97%; there was a significant difference between the two groups (χ²=4.717, P=0.030). The proportion of patients with intracranial demyelination was significantly higher in Group 1 than in Group 2 (47.92% vs 24.36%, χ²=7.421, P=0.006).

Conclusion

Patients with acute cerebral infarction caused by small artery occlusion are not uncommon in Lhasa area. The risk factors for cognitive impairment include diabetes mellitus, high altitude erythrocytosis, and severe intracranial demyelination.

Key words: Arterial occlusive disease, Cerebral infarction, Cognitive disorders, Risk factor

Xiaoxuan Liu, Zhuoga Cidan, Zhuoma, Yuhua Zhao. Risk factors for cognitive impairment in patients with acute cerebral infarction due to small artery occlusion[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(03): 175-179.

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References 15

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分组	例数	发病年龄（岁）	男/女（例）	藏族患者［例（%）］	高血压［例（%）］	高血脂（低密度脂蛋白>2.6 mmol/L）［例（%）］	冠心病［例（%）］	糖尿病［例（%）］	高原红细胞增多症［例（%）］
认知功能障碍组	48	60.58±11.28	26/22	40（83.33）	37（77.08）	41（85.41）	10（20.83）	15（31.25）	11（22.92）
认知功能正常组	78	58.73±11.67	40/38	67（85.59）	53（67.95）	63（80.77）	14（17.95）	11（14.10）	7（8.97）
统计值	?	t=0.876	χ²=0.099	χ²=0.696	χ²=1.215	χ²=0.445	χ²=0.16	χ²=5.335	χ²=4.717
P值	?	0.382	0.753	0.441	0.270	0.505	0.689	0.021	0.030
分组	例数	同型半胱氨酸增高［例（%）］	尿酸增高［例（%）］	文化程度（例）			影像学表现［例（%）］
分组	例数	同型半胱氨酸增高［例（%）］	尿酸增高［例（%）］	文盲	小学（<6年）	中学及以上（≥6年）	腔隙性脑梗死（>5个病灶）	脑白质病变
认知功能障碍组	48	10（20.83）	8（16.67）	15	12	21	19（39.58）	23（47.92）
认知功能正常组	78	13（16.67）	12（15.38）	20	22	36	21（26.92）	19（24.36）
χ²值	?	0.346	0.037	?	0.657	?	2.198	7.421
P值	?	0.557	0.848	?	0.72	?	0.138	0.006

分组	例数	发病年龄（岁）	男/女（例）	藏族患者［例（%）］	高血压［例（%）］	高血脂（低密度脂蛋白>2.6 mmol/L）［例（%）］	冠心病［例（%）］	糖尿病［例（%）］	高原红细胞增多症［例（%）］
认知功能障碍组	48	60.58±11.28	26/22	40（83.33）	37（77.08）	41（85.41）	10（20.83）	15（31.25）	11（22.92）
认知功能正常组	78	58.73±11.67	40/38	67（85.59）	53（67.95）	63（80.77）	14（17.95）	11（14.10）	7（8.97）
统计值	?	t=0.876	χ²=0.099	χ²=0.696	χ²=1.215	χ²=0.445	χ²=0.16	χ²=5.335	χ²=4.717
P值	?	0.382	0.753	0.441	0.270	0.505	0.689	0.021	0.030
分组	例数	同型半胱氨酸增高［例（%）］	尿酸增高［例（%）］	文化程度（例）			影像学表现［例（%）］
分组	例数	同型半胱氨酸增高［例（%）］	尿酸增高［例（%）］	文盲	小学（<6年）	中学及以上（≥6年）	腔隙性脑梗死（>5个病灶）	脑白质病变
认知功能障碍组	48	10（20.83）	8（16.67）	15	12	21	19（39.58）	23（47.92）
认知功能正常组	78	13（16.67）	12（15.38）	20	22	36	21（26.92）	19（24.36）
χ²值	?	0.346	0.037	?	0.657	?	2.198	7.421
P值	?	0.557	0.848	?	0.72	?	0.138	0.006

变量	B	标准误	Wald χ²	P值	OR	95%CI
糖尿病	1.057	0.500	4.474	0.034	2.877	1.081~7.659
高原红细胞增多症	1.410	0.592	5.661	0.017	2.694	1.282~8.076
较严重的脑白质脱髓鞘	1.191	0.471	6.399	0.011	3.29	1.308~8.277
常数	-0.887	0.568	2.436	0.119	-	-

变量	B	标准误	Wald χ²	P值	OR	95%CI
糖尿病	1.057	0.500	4.474	0.034	2.877	1.081~7.659
高原红细胞增多症	1.410	0.592	5.661	0.017	2.694	1.282~8.076
较严重的脑白质脱髓鞘	1.191	0.471	6.399	0.011	3.29	1.308~8.277
常数	-0.887	0.568	2.436	0.119	-	-

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