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Stroke:新概念“认知功能储备”对脑卒中患者认知功能影响如何?

2020-03-30 shaosai MedSci原创

由于不同个体对于临床神经病认知损害具有差异性,才引入了认知储备(CR)的理论。本研究旨在评价是否CR对脑卒中后认知损害因素及认知功能恢复具有影响。

背景和目的

由于不同个体对于临床神经病认知损害具有差异性,才引入了认知储备(CR)的理论。本研究旨在评价是否CR对脑卒中后认知损害因素及认知功能恢复具有影响。

方法

本研究对7459例首发脑卒中患者进行分析。以教育程度、职业和综合上述2方面获取的CR评分作为代表CR的指标。分析受试者脑卒中30个月的简化精神状态量表(韩国版)评分。

结果

患者CR越低,脑卒中后认知损害风险越高。与高等教育患者相比,中等教育患者和初等教育患者的OR分别为1.89 (95% CI, 1.64-2.19) 、2.42 (95% CI, 2.03-2.90)。与管理者或专业性工种相比,技巧性劳力工种和非技巧性劳力工种的OR分别为1.48 (95% CI, 1.23-1.98) 、2.01 (95% CI, 1.42-2.83)。在多水平模型分析中,简易精神状态评分在头3个月升高(平均每月1.93分),随即达到平稳期(平均每月0.02分)。根据教育水平、职业和综合CR评分,斜率有所调整:教育水平、工种和CR评分越高,恢复越快。在老年组,简易精神状态评分显示教育水平对认知下降具有远期影响。

结论

教育程度和职业会是的脑卒中患者认知功能下降速度延缓,同时提高脑卒中后认知功能恢复速度。此外,教育程度越高,脑卒中后认知功能远期下降程度越小,尤其是老年人。

原始出处:

Shin M, Sohn MK, Lee J.et al. Effect of Cognitive Reserve on Risk of Cognitive Impairment and Recovery After Stroke: The KOSCO Study. DOI: 10.1161/STROKEAHA.119.026829

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1720333, encodeId=da4d1e203331c, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 05 00:22:32 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1679144, encodeId=c4bd16e9144c1, content=<a href='/topic/show?id=7a2684e600b' target=_blank style='color:#2F92EE;'>#脑卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84760, encryptionId=7a2684e600b, topicName=脑卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091e27733095, createdName=weihongyv, createdTime=Mon Sep 21 17:22:32 CST 2020, time=2020-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026604, encodeId=31f810266046f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Mar 31 02:22:32 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=381167, encodeId=08ac38116e19, content=啊啊啊啊啊啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b705315496, createdName=石贤清, createdTime=Tue Mar 31 00:03:48 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=381164, encodeId=bd203811642f, content=不错不错不错不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b705315496, createdName=石贤清, createdTime=Mon Mar 30 23:49:36 CST 2020, time=2020-03-30, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1720333, encodeId=da4d1e203331c, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 05 00:22:32 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1679144, encodeId=c4bd16e9144c1, content=<a href='/topic/show?id=7a2684e600b' target=_blank style='color:#2F92EE;'>#脑卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84760, encryptionId=7a2684e600b, topicName=脑卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091e27733095, createdName=weihongyv, createdTime=Mon Sep 21 17:22:32 CST 2020, time=2020-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026604, encodeId=31f810266046f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Mar 31 02:22:32 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=381167, encodeId=08ac38116e19, content=啊啊啊啊啊啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b705315496, createdName=石贤清, createdTime=Tue Mar 31 00:03:48 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=381164, encodeId=bd203811642f, content=不错不错不错不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b705315496, createdName=石贤清, createdTime=Mon Mar 30 23:49:36 CST 2020, time=2020-03-30, status=1, ipAttribution=)]
    2020-03-31 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1720333, encodeId=da4d1e203331c, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 05 00:22:32 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1679144, encodeId=c4bd16e9144c1, content=<a href='/topic/show?id=7a2684e600b' target=_blank style='color:#2F92EE;'>#脑卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84760, encryptionId=7a2684e600b, topicName=脑卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091e27733095, createdName=weihongyv, createdTime=Mon Sep 21 17:22:32 CST 2020, time=2020-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026604, encodeId=31f810266046f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Mar 31 02:22:32 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=381167, encodeId=08ac38116e19, content=啊啊啊啊啊啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b705315496, createdName=石贤清, createdTime=Tue Mar 31 00:03:48 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=381164, encodeId=bd203811642f, content=不错不错不错不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b705315496, createdName=石贤清, createdTime=Mon Mar 30 23:49:36 CST 2020, time=2020-03-30, status=1, ipAttribution=)]
    2020-03-31 石贤清

    啊啊啊啊啊啊

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1720333, encodeId=da4d1e203331c, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 05 00:22:32 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1679144, encodeId=c4bd16e9144c1, content=<a href='/topic/show?id=7a2684e600b' target=_blank style='color:#2F92EE;'>#脑卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84760, encryptionId=7a2684e600b, topicName=脑卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091e27733095, createdName=weihongyv, createdTime=Mon Sep 21 17:22:32 CST 2020, time=2020-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026604, encodeId=31f810266046f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Mar 31 02:22:32 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=381167, encodeId=08ac38116e19, content=啊啊啊啊啊啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b705315496, createdName=石贤清, createdTime=Tue Mar 31 00:03:48 CST 2020, time=2020-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=381164, encodeId=bd203811642f, content=不错不错不错不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b705315496, createdName=石贤清, createdTime=Mon Mar 30 23:49:36 CST 2020, time=2020-03-30, status=1, ipAttribution=)]
    2020-03-30 石贤清

    不错不错不错不错不错

    0

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