缺血性中风后的认知障碍

Mosaab Omran, N. Ibrahim, M. Zaki
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引用次数: 2

摘要

背景与目的缺血性脑卒中患者通常具有良好的运动功能恢复,预后良好。本研究的目的是评估脑卒中早期认知功能障碍的神经认知状态的预后价值,评估首次缺血性脑卒中后的预后,并选择适当的脑卒中认知功能障碍预防管理。对缺血性脑卒中患者进行前瞻性评估,分别使用蒙特利尔认知评估(MoCA)和迷你精神状态检查(MMSE),并结合美国国立卫生研究院卒中量表(NIHSS),在亚急性卒中期或2周内(基线),以及修改的Rankin量表(mRS)评分,评估3个月和6个月后的功能结局。结果37.5%的患者在基线时被诊断为认知障碍,中位NIHSS=4,中位mRS=2 (P2),基线MoCA和MMSE对基线NIHSS在3个月和6个月时的mRS评分具有中等较大的显著预测价值。结论亚急性期认知状态筛查可独立预测脑卒中功能结局,提高脑卒中严重程度评分的预测价值。评估什么是认知是很重要的,简短的认知测试可能有助于在早期阶段进行评估。
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Cognitive impairment after first-ever ischemic stroke
Background and aim Ischemic stroke has a good outcome because these patients usually have a good motor recovery. The aim of this work was to assess the prognostic value of the neurocognitive status to detect early cognitive dysfunction in stroke phases, evaluate outcome after first-ever ischemic stroke, and to choose proper preventive management of stroke cognitive dysfunction. Patients and methods Patients with ischemic stroke were prospectively evaluated using Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) individually and in combination with National Institutes of Health Stroke Scale (NIHSS), either at the subacute stroke phase or within 2 weeks (baseline), and modified Rankin scale (mRS) scores, for functional outcome 3 and 6 months later. Results Cognitive impairment was diagnosed at baseline in 37.5% of patients with median NIHSS=4 and median mRS=2 (P<0.001). Baseline NIHSS, MMSE, and MoCA can individually predict mRS scores at 3 and 6 months, and NIHSS is the strongest predictor. However, patients with more disability at baseline (NIHSS>2), baseline MoCA, and MMSE had a moderately large significant predictive value to the baseline NIHSS for mRS scores at 3 and 6 months. Conclusion Screening of cognitive state at the subacute stroke phase can predict functional outcome independently and improve the predictive value of stroke severity scores. And it is important to evaluate what cognition is, and the brief cognitive test may facilitate assessment in the early phases.
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审稿时长
34 weeks
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