目的 探讨缺血性脑卒中后非痴呆认知功能障碍(cognitive impairment no dementia,CIND)的危险因素.方法 以19～80岁汉族初发缺血性脑卒中患者为研究对象,起病后3个月采用简易智能量表和美国精神疾病统计和诊断于册第4版修订本进行认知测定,利用单因素和多元Logistic回归分析研究CIND患者的危险因素.结果 185例研究对象纳入统计分析,42例诊断为CIND,占22.7%.多因素Logistic回归分析发现,大面积和中等面积梗死(OR:4.687,P＜0.05;OR:4.734,P＜0.05)、糖尿病(OR:2.887,P＜0.05)是缺血性卒中后CIND的独立危险因素.结论 糖尿病、梗死面积是缺血性脑卒中后CIND的独立危险因素.%Objective Cognitive impairment without dementia(CIND) is common and more predictable to the development of dementia, lschemic stroke accounts for 43.7% ～ 78.9% of all stroke in china and contributes to most cases of vascular cognitive impairment(VCI). The purpose of this study is to determine the frequency and risk factors of CIND in a hospital cohort after first ischemic stroke during a 3-month follow up in China. Methods One hundred eighty-five ischemic stroke patients were interviewed by a psychiatrist 3 months after their stroke. Cognitive impairment was determined according to the Chinese version of Mini-Mental State Examination(MMSE) and Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ-R). CIND was established if the patient with cognitive impairment did not fulfill the DSM-Ⅳ criteria of dementia. Univariate and logistic regression analysis was used for statistical analysis. Results A total of 22. 7% patients had CIND after 3 months. Univariate analysis found that CIND was associated with hypertension, atrial fibrillation, and infarct volume. Multivariate logistic regression suggested that diabetes(or: 2.887, P ＜0.05) and infarct volume(or:4.734, P ＜ 0.05) were the independent risk factors of CIND of post-ischemic stroke. Conclusions CIND are frequent in patients after isehemic stroke in china. Effective control of diahetes should be recommended as a feasible preventive measures of CIND should be suggested.
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