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目的分析卒中患病时间对北京市老年人群认知功能的影响。方法基于北京市慢病合并常见老年综合征社区管理规范研究课题,采用横断面研究方法,自2013年7月至2014年12月通过多阶段、随机、分层的抽样方法对北京市4个区县(西城区、房山区、通州区、延庆县)的老年人群进行抽样,共纳入研究对象3 024名。采用问卷调查和临床检查获取数据,以简易精神状态检查量表(MMSE)评分为认知功能的评价指标,依据MMSE量表评分情况,将研究对象分为认知功能正常组(MMSE>26分,1 878名)和认知功能障碍组(MMSE≤26分,1 146例)。采用多因素Logistic回归模型分析出血性卒中、缺血性卒中及无症状卒中的患病情况及患病时间对认知功能的影响。结果经校正性别、年龄、受教育程度、婚姻、吸烟、饮酒等混杂因素后,患病1~3年、4~1 0年、>1 0年的出血性卒中患者发生认知功能障碍的风险分别为未发生卒中人群的3.019(95%CI:0.974~9.361,P=0.056)、8.652(95%CI:2.924~25.601,P<0.01)、1.104倍(95%CI:0.311~3.920,P=0.879);患病1~3年、4~10年、>10年的缺血性卒中患者发生认知功能障碍的风险分别为未发生卒中人群的1.000(95%CI:0.636~1.571,P=1.000)、1.874(95%CI:1.231~2.853,P=0.003)、2.439倍(95%CI:1.386~4.291,P=0.002)。出血性卒中患者患病4~10年及缺血性卒中患者患病4~10年、>10年均为认知功能障碍发生的危险因素。结论对于卒中患者,卒中患病时间或长期效应对认知功能有一定影响。
Objective To analyze the influence of the prevalence of stroke on the cognitive function of the elderly population in Beijing. Methods Based on the research project of community management standard of common diseases of elderly patients with chronic diseases in Beijing and the method of cross-sectional study, from July 2013 to December 2014, four districts in Beijing were studied by means of multistage, random and stratified sampling methods. (Xicheng District, Fangshan District, Tongzhou District, Yanqing County) of the elderly population sampling, a total of 3 024 study subjects were included. Data were collected by questionnaire and clinical examination. MMSE score was used as evaluation index of cognitive function. According to MMSE scale score, subjects were divided into cognitive function group (MMSE> 26 , 1 878) and cognitive impairment group (MMSE≤26 points, 1 146 cases). Multivariate Logistic regression model was used to analyze the prevalence of hemorrhagic stroke, ischemic stroke and asymptomatic stroke, and the effect of illness time on cognitive function. Results The risk of cognitive impairment occurred in patients with hemorrhagic stroke who had 1 to 3 years, 4 to 10 years, and 10 years after adjustment for such factors as gender, age, education level, marriage, smoking and alcohol consumption Were 3.019 (95% CI: 0.974-9.361, P = 0.056), 8.652 (95% CI 2.924-25.601, P <0.01) and 1.104 times (95% CI: 0.311-3.920, P = 0.879). The risk of cognitive impairment in patients with ischemic stroke of 1 to 3 years, 4 to 10 years and> 10 years were 1.000 (95% CI: 0.636 to 1.571, P = 1.000), 1.874 (95% CI: 1.231-2.853, P = 0.003), 2.439-fold (95% CI: 1.386-4.291, P = 0.002). Hemorrhagic stroke patients suffering from 4 to 10 years and ischemic stroke patients suffering from 4 to 10 years,> 10 years are cognitive risk factors. Conclusions For stroke patients, the prevalence of stroke or long-term effects have some effect on cognitive function.