目的本文旨在探讨性别、年龄、卒中类型和卒中后失语症分类间的关系。 方法回顾性分析2005年7月～2012年7月首都医科大学附属北京天坛医院收治的符合病例入排标准的421例急性卒中患者，应用北京大学第一医院神经内科汉语失语检查法中的利手评定标准进行利手判定、西部失语成套测验进行失语症的分类及失语指数（Aphasia Quotient，AQ）评分，按照年龄不同分为青、中、老年三组，按卒中类型分为脑梗死及脑出血，结合不同性别观察失语症类型的分布情况，比较不同年龄、性别以及卒中类型间失语症类型分布有无差异。 结果入选患者均为右利手，男性占69.60%，女性占30.40%。失语症类型如下：运动性失语116例（男85例，女31例），感觉性失语35例（男20例，女15例），传导性失语15例（男10例，女5例），经皮质运动性失语63例（男50例，女13例），经皮质感觉性失语11例（男8例，女3例），经皮质混合性失语27例（男13例，女14例），命名性失语73例（男47例，女26例），完全性失语81例（男60例，女21例），经统计学分析，男性卒中后失语症发生率（69.60%）明显高于女性（30.40%）（χ2=11.57，P=0.003），尤以青中年（≤65岁）为主（73.38%），老年期（>65岁）女性发生率逐渐升高（42.97%），与男性差异逐渐缩小（26.28%）；性别对失语症类型无明显影响（χ2=13.84，P=0.054），男女患者均以运动性失语最常见（分别为29.01%、24.22%）；各年龄组患者失语类型分布无明显差异（χ2=14.94， P=0.382）。脑梗死所致失语症患者较脑出血所致者更为多见（分别为306例和115例），但在失语症类型分布上差异无显著性（χ2=13.23，P=0.067），除女性脑出血患者外，均以运动性失语最为常见（分别为29.82%，29.55%，26.67%）。 结论年龄、性别及卒中类型对卒中后失语症类型分布均无明显影响，男性卒中后失语发生率明显高于女性且患病平均年龄小于女性，两性中均以运动性失语最常见；除去女性脑出血患者外，均以运动性、完全性及命名性失语最常见。%Objective To explore the association between the types of aphasia and sex, age and stroke types. Methods Four hundred and twenty-one aphasiacs after stroke who met the inclusion and exclusion criteria and were admitted to Department of Neurology of Beijing Tiantan Hospital, Capital Medical University from July 2005 to July 2012 were restrospectively analyzed. The criteria of handedness instituted by Peking University First Hospital was used to judge patients' handedness. Western battery aphasia was used to assess the aphasiac type and calculate Aphasia Quotient (AQ) score. Patients were divided into youth, middle-aged and elderly groups, and stroke types include cerebral infraction (CI) and intracerebral hemorrhage (ICH). Finally we analyzed the types of aphasia in different ages, sex and stoke types. Results All subjects were dextromanual, in whom males and females accounted for 69.60%and 30.40%, respectively. The types of aphasia included Broca's aphasia (male 85, female 31), Wernicke's aphasia (male 20, female 15), conductive aphasia (male 10, female 5), transcortical motor aphasia (male 50, female 13), transcortical sensory aphasia (male 8, female 3), transcortical combined aphasia (male 13, female 14), anomic aphasia (male 47, female 26) and global aphasia (male 60, female 21). Male patients (69.60%) have a signiifcantly higher level of morbidity of aphasia than females (30.40%) after stroke (χ2=11.57, P=0.003), especially those under 65 years old (73.38%). After 65 years old, the morbidity of female tends to increase with age (42.97%). Sex has no remarkable effect on the types of aphasia (χ2=13.84, P=0.054), Broca's aphasia is the most common types in both males and females (29.01%, 24.22%, respectively). The distribution of aphasic types has no obvious difference among three age groups (χ2=14.94, P=0.382). Aphasia induced by CI (306 cases) is more common than by ICH (115 cases), but the distribution of types of aphasia has no difference (χ2=13.23, P=0.067). Broca's aphasia is the most common aphasic type in both CI and ICH patients (29.82%, 29.55%, 26.67%, respectively), except the females with ICH. Conclusion Age, sex and stroke types have no signiifcant inlfuence on the types of aphasia. Male patients have a signiifcantly higher level of morbidity of aphasia than females after stroke as well as the average age of onset is younger than females. Broca's aphasia is the most common one in both males and females. Broca's aphasia, global and anomic aphasia are the most aphasic types in both CI and ICH patients, except the females with ICH.
展开▼
