短暂性脑缺血发作及轻型卒中患者认知功能下降的随访研究

摘要

Objetive The present study was aimed to explore the risk factors of mid-term cognitive decline in pa⁃tients with indexed TIA/minor stroke (NIHSS≤3) in a Chinese hospital-based cohort. Methods We recruited all consec⁃utive Chinese TIA/minor stroke patients from July to December in 2012 and followed them up in stroke clinics at 3 and 18 months after indexed TIA/minor stroke. The outcome was defined as significantly cognitive decline at 18 months com⁃pared with that at 3 months. Results A total of 209 consecutive Chinese TIA/minor stroke cases completed their fol⁃low-up investigation. Among them, 24 (11.5%) exhibited significantly cognitive decline. The independent risk factors of cognitive decline post TIA/minor stroke were education years (OR=0.869,P=0.021), atrial fibrillation(OR=5.950, P=0.001) and multiple silent lacunar infarcts (OR=5.179,P=0.020). Conclusion It is necessary to evaluate the cognition among TIA/minor stroke cases and a close follow-up is required for patients with atrial fibrillation and multiple silent la⁃cunar infarcts frequently in order to decrease the risk of cognitive decline post TIA/minor stroke.%目的：既往的研究对短暂性脑缺血发作(transient ischemic attack, TIA)及轻型卒中后的认知功能障碍的关注较少。我们将对此类患者发生认知功能障碍的危险因素进行探讨。方法我们筛选了2012年7月至12月期间，连续住院的TIA及轻型卒中患者。于发病后第3个月及第18个月各进行一次认知功能评估，截止至2014年3月31日。结果共209例TIA及轻型卒中患者入组。其中，共24例(11.5%)出现了认知功能显著下降。Logistic回归分析，结果显示：受教育年限（比数比OR=0.869，P=0.021），心房纤颤（OR=5.950, P=0.001）、多发性腔隙性脑梗死（OR=5.179，P=0.020）是TIA/轻型卒中患者中远期认知功能下降的独立危险因素。结论对于TIA/轻型卒中的患者有必要对其认知功能进行随访，对于有心房纤颤及颅内多发性腔隙性脑梗死的患者应关注其认知功能变化，加强随访，必要时尽早给予干预治疗措施，以减少其发生认知功能下降的风险。