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目的:对急性缺血性脑卒中患者的认知功能进行评定,探讨认知功能障碍的相关因素。方法:纳入急性缺血性脑卒中患者86例作为研究组,按1:1比例,以性别、年龄和教育程度相匹配的同社区健康人作为对照。用洛文斯顿作业疗法认知评定成套测验(Loewenstein Occu-pational,Therapy Congnitive Assessment,LOTCA)为评定工具,于卒中后3个月对患者认知功能进行评定。结果:(1)与对照组比较,研究组LOTCA各项及总得分均较低,差异有显著性(P<0.01);(2)高年龄、低学历、饮酒、高血压病史、糖尿病史、血脂异常、大病灶患者的LOTCA认知得分较低(P<0.05或P<0.01),不同性别之间和卒中半球的LOTCA认知得分无统计学差异。结论:(1)急性缺血性脑卒中患者存在定向、视知觉、空间知觉、动作运用、视运动组织、思维操作等广泛的认知功能损害。(2)其认知功能改变与年龄、学历、卒中病灶大小、高血压史、糖尿病史、血脂谱等相关。
Objective: To evaluate the cognitive function of patients with acute ischemic stroke and to explore the related factors of cognitive dysfunction. Methods: A total of 86 patients with acute ischemic stroke were enrolled in the study. Patients in the community were matched according to their sex ratio, age, and educational attainment in a ratio of 1: 1. Patients were assessed for cognitive function at 3 months after stroke using the Loewenstein Occu-pational, Therapy Congnitive Assessment (LOTCA) as a measurement tool. Results: (1) Compared with the control group, the scores of LOTCA in the study group were lower and the total score was lower (P <0.01); (2) The patients with higher age, lower education, alcohol consumption, history of hypertension, In patients with dyslipidemia and major lesion, the LOTCA cognitive score was lower (P <0.05 or P <0.01). There was no significant difference in LOTCA cognitive score between different sexes and stroke hemisphere. Conclusion: (1) There is a wide range of cognitive impairment in patients with acute ischemic stroke, such as orientation, visual perception, spatial perception, motor use, visual movement, and mental manipulation. (2) The changes of cognitive function were related to age, education level, the size of stroke focus, history of hypertension, history of diabetes, lipid profile and so on.