中風後認知障礙與顱內血管阻塞之關聯性分析

A Study on the Correlation between Cognitive Impairment and Intracranial Vascular Occlusion for Patients after a Stroke

10.30156/CCMJ.201207.0002

張炳華(Bin-Wha Chang)；曾庭儀(Ting-Yi Tseng)；劉美玉(Mei-Yu Liu)；李詠慧(Yong-Hui Lee)；葉守正(Shoou-Jeng Yeh)

中風 ； 顱內血管阻塞 ； 認知功能障礙 ； 複合式血管阻塞指標 ； Stroke ； intracranial vessel occlusion ； cognition impairment ； composite intra-cerebral stenosis score

澄清醫護管理雜誌

8卷3期（2012 / 07 / 01）

9 - 17

繁體中文

PurposePCognitive impairment after a stroke resulting in brain defects is a key factor in causing disability. In general, the level of damage to brain tissue is positively related to intracranial vessel occlusion (IVO). Therefore, the purpose of this study was to analyze the relationship between cognition impairment and IVO after a stroke.MethodThe subjects were stroke patients with treatment records in a regional teaching hospital in central Taiwan. Inclusion criteria were: first stroke, hospitalization within 3 days after the stroke, age less than 80 years, and no history of dementia. Patients with severe strokes (NIHSS＞15) were excluded. The Mini Mental Status Examination (MMSE) was used to monitor cognitive impairment and the composite intra-cerebral stenosis score (CISS) to evaluate the IVO level.ResultsResults showed that of the 201 eligible patients, 127 (63.2%) were male and 74 (36.8%) were female. Age ranged from 50 to 80, and the average was 62.8 years (the standard deviation was 11.2 years). In terms of IVO distribution, there was no significant IVO (CISS=0) in 148(73.6%) cases, a single IVO (CISS=1) in 21 (10.4%) cases, and multiple IVOs (CISS＞=2) in 32(16.0%) cases. For cognitive function, the results showed that on MMSE assessment six months after discharge, the scores were significantly higher than those on the assessments made in the third month or during admission phase (p ＜0.05). This showed that the damage due to IVO could be controlled with appropriate medical and home care to effectively improve cognition function. For the group with CISS 0, their cognitive function scores three and six months after discharge were significantly better than those during admission (p＜0.05). The results also showed that IVO damage was greater in diabetics.ConclusionsIn addition, 79.1% of our patients had hypertension. We therefore suggest that hospital administrations need to strengthen education and care for diabetic and hypertensive patients who live in hospitals or long term-care facilities to prevent permanent injury and cognitive dysfunction as the result of a stroke.

PurposePCognitive impairment after a stroke resulting in brain defects is a key factor in causing disability. In general, the level of damage to brain tissue is positively related to intracranial vessel occlusion (IVO). Therefore, the purpose of this study was to analyze the relationship between cognition impairment and IVO after a stroke.MethodThe subjects were stroke patients with treatment records in a regional teaching hospital in central Taiwan. Inclusion criteria were: first stroke, hospitalization within 3 days after the stroke, age less than 80 years, and no history of dementia. Patients with severe strokes (NIHSS＞15) were excluded. The Mini Mental Status Examination (MMSE) was used to monitor cognitive impairment and the composite intra-cerebral stenosis score (CISS) to evaluate the IVO level.ResultsResults showed that of the 201 eligible patients, 127 (63.2%) were male and 74 (36.8%) were female. Age ranged from 50 to 80, and the average was 62.8 years (the standard deviation was 11.2 years). In terms of IVO distribution, there was no significant IVO (CISS=0) in 148(73.6%) cases, a single IVO (CISS=1) in 21 (10.4%) cases, and multiple IVOs (CISS＞=2) in 32(16.0%) cases. For cognitive function, the results showed that on MMSE assessment six months after discharge, the scores were significantly higher than those on the assessments made in the third month or during admission phase (p ＜0.05). This showed that the damage due to IVO could be controlled with appropriate medical and home care to effectively improve cognition function. For the group with CISS 0, their cognitive function scores three and six months after discharge were significantly better than those during admission (p＜0.05). The results also showed that IVO damage was greater in diabetics.ConclusionsIn addition, 79.1% of our patients had hypertension. We therefore suggest that hospital administrations need to strengthen education and care for diabetic and hypertensive patients who live in hospitals or long term-care facilities to prevent permanent injury and cognitive dysfunction as the result of a stroke.