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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Cognitive Decline in Patients with Leukoaraiosis Within 5 Years after Initial Stroke
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Cognitive Decline in Patients with Leukoaraiosis Within 5 Years after Initial Stroke

机译：初步中风后5年内患者患者的认知下降

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Background: Leukoaraiosis (LA) is closely associated with cognitive deficits. The association between LA and cognitive disorders, such as mild cognitive impairment (MCI) and dementia, after initial stroke has not been systematically studied. In this study, we sought to identify whether LA contributes to the occurrence of certain type of cognitive disorders after initial stroke. Methods: Data from our Stroke Registry were examined, and 5-year follow-up data for LA and cognitive disorders were analyzed. We performed Kaplan-Meier analysis and log-rank test to assess the predictive value of LA for risk of cognitive decline and the Cox proportional hazards model to test the risk factors studied as independent determinants of cognitive impairment. Results: The frequency of patients with normal cognitive function decreased significantly at 5 years compared with initial stroke (78% vs 70%; odds ratio, 1.51; 95% confidence interval, 1.41-1.62). Of 8784 patients, 1659 (19%) had dementia and 964 (11%) had MCI at the final analysis. After 5 years of follow-up, survival analysis showed that all patients with LA had an increased probability of MCI compared with those without LA (P < .0001). Patients with LA had an increased chance of dementia compared with those without LA(P < .0001) at the end of follow-up. Cognitive decline probability was significantly higher in patients with severe LA compared with those with mild/moderate LA(P < .0001). Cox regression analyses showed that recurrence of stroke (hazard ratio[HR], 3.92 [95% CI, 3.26-4.72]), hypertension(HR, 1.11 [95% CI, 1.0-1.22]), LA(HR, 1.15 [95% CI, 1.05-1.25]), age (HR, 1.05 [95% CI, 1.04-1.06]), hypercholesterolemia (HR, .86 [95% CI, .77-.95]), higher LDL cholesterol (HR, 1.21 [95% CI, 1.11-1.32]), lower HDL cholesterol (HR, .90 [95% CI, .83-.98]), coronary heart disease (HR, .85 [95% CI, .77-.94]), and National Institutes of Health Stroke Scale score at admission (HR, .77 [95% CI, .72-.82]) were also significantly associated with cognitive impairments. Conclusions: Our findings suggest that patients with LA may be at risk of developing new cognitive impairments at long-term period after initial stroke. The evaluation of the concomitant risk factors, besides providing insights about the possible mechanisms behind the cognitive dysfunction present in LA, may be of help for the prevention of cognitive impairments.
机译：背景：Leukoaraiosis（La）与认知赤字密切相关。在初始中风后，La和认知障碍之间的关联，例如轻度认知障碍（MCI）和痴呆症，尚未得到系统地研究。在这项研究中，我们试图识别La是否有助于在初始中风后发生某种类型的认知障碍。方法：检查了来自笔划注册表的数据，分析了洛杉矶和认知障碍的5年后续数据。我们进行了Kaplan-Meier分析和日志秩检验，以评估La的预测值，以便认知下降风险和Cox比例危险模型测试作为认知障碍的独立决定因素所研究的风险因素。结果：与初始中风相比，患有正常认知功能患者的患者的频率明显减少（78％vs 70％;差距为1.51; 95％置信区间，1.41-1.62）。在8784名患者中，1659名（19％）患有痴呆，964（11％）在最终分析中具有MCI。在5年后的随访后，存活分析表明，与没有LA的人相比，所有LA患者的概率都会增加MCI（P <.0001）。与随访结束时，患者的患者与没有LA（P <.0001）的人相比，痴呆的几率增加。与温和/中等LA的患者相比，患者的认知衰减概率显着高（P <.0001）。 COX回归分析表明，中风复发（危害比[HR]，3.92 [95％CI，3.26-4.72]），高血压（HR，1.11 [95％CI，1.0-1.22]），LA（HR，1.15 [95] ％CI，1.05-1.25]）年龄（HR，1.05 [95％CI，1.04-1.06]），高胆固醇血症（HR，.86 [95％CI，0.77-.95]），较高的LDL胆固醇（HR， 1.21 [95％CI，1.11-1.32]），低于HDL胆固醇（HR，.90 [95％[95％CI，.83-.98]），冠心病（HR，.85 [95％CI，.77-。 94]），以及入院（HR，.77 [95％CI，0.72-.82]）的国家卫生卒中量表评分也与认知障碍有关。结论：我们的研究结果表明，LA患者可能存在在初步中风后长期期间开发新的认知障碍的风险。除了提供关于在LA中存在的认知功能障碍后面可能的机制的见解之外，评价伴随的风险因素可能有助于预防认知障碍。

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