The Incidence And Related Risk Factors Analysis Of Vascular Cognitive Impairment In Inpatients With Psot Stroke Depression

Objective: To explore the relationship between post stroke depression(PSD) andVascular cognitive impairment(VCI), annalyze the incidence of VCI and related riskfactors.Method:1.Select230inpatients of neurology at the Second Affiliated Hospital of DalianMedical University diagnosed with stroke from March2012to November2013, accordwith ICD-10F32, the diagnostic criteria for depression, divied the inpatients with strokeinto two groups, there are120inpatients in PSD group and110inpatients in NPSDgroup. According to Montreal Cognitive Assessment (MoCA) Beijing Version andclassification and diagnostic of VCI in―Diagnosis and treatment guideline‖formulatedby The Chinese medical association of neurology branch of dementia and cognitiveimpairment group (this paper does not to grade and classiy VCI). Divide PSD Groupinto VCI group of84inpatients and NVCI group of38inpatients.2. Make Statistics the incidence of PSD in inpatients of stoke,the incidence of VCIin inpatients of stoke, the incidence of VCI in PSD group and NPSD group, theincidence of VCI in inpatients of first stroke and second or more stroke, the incidence ofVCI in mild to moderate PSD and major PSD. 3. Analyze the possible risk factors (natural factor:gender,age,education years;biological factor: smoke, drink, body mass index, type2diabetes, hypertension,hypertension grade2and3, hypertension grade3, carotid artery atherosclerotic, artialfibrillation, leukoaraiosis) with single factor analysis, find out the factor with statisticaldifference in two groups.4. To introduce factors with statistical differences that after single factor analysisinto multi-factors unconditional Logistic regression analysis model, utilize VCI asdependent variable to conduct multi-factors statistics analysis, learn about independentrisk factors that related to VCI.5. Analyze the correlation between the score of Hamilton depression scaleother-evaluation24version and the score of Montreal Cognitive Assessment (MoCA)Beijing Version.Results:1. The incidence of PSDThe incidence of PSD is52.17%. The incidence of mild to moderate PSD is41.74%,the incidence of major PSD is10.43%.2.The incidence of VCIThe incidence of VCI in inpatients of stoke is67.82%. In NPSD group,theincidence of VCI is65.46%, the incidence of VCI in inpatients of first stroke is64.20%,the incidence of VCI in inpatients of second or more stroke is68.97%.In PSDgroup,The incidence of VCI is70.00%, the incidence of VCI in inpatients of first strokeis67.39%, the incidence of VCI in inpatients of second or more stroke is78.57%.Theincidence of VCI in mild to moderate PSD is65.6%, The incidence of VCI in majorPSD is87.5%.3. Single factor analysis:Hypertension,Hypertension grade2and3has statistical meaning between VCIgroup and NVCI group (P＜0.05);age,Hypertension grade3, type2diabetes,leukoaraiosis has significant statistical meaning between VCI group and NVCI group (P＜0.01) 4. Logistic regression analysis:Leukoaraiosis(OR=6.503，95%,95%CI:2.278-18.566), type2diabetes(OR=5.524，95%CI:1.403-21.751),age(OR=1.133，95%CI:1.035-1.240), Hypertension grade3(OR=16.925，95%CI:2.240-127.861), the above four variables have statistical meaning(P<0.05).5. Spearman ’s rank correlation coefficient analysisThe correlation coefficient between the score of HAMD and the score of MoCA is-0.818<0.The two variables are negative correlation,PSD is heavier,the worse iscognitive function.The bilateral test of the correlation coefficient isP=0.00*<0.01,shows that the coefficient has significant statistical meaning.Conclusion:1.In the acute phase of stroke,the incidence of PSD is as high as52.17%,theincidence of mild to moderate PSD is higher than the major PSD.2.The incidence of PSD patients VCI is higher than stroke patients with andwithout PSD.With the increase of number of stroke, the incidence of VCI has alsoincreased.3.Older they got,the incidence of VCI is higher,hypertension, hypertension grade2and3, hypertension grade3, type2diabetes, leukoaraiosis maybe the related risk factorof VCI in PSD inpatients.4.Leukoaraiosis, type2diabetes,age, hypertension grade3is independent riskfactor of VCI in PSD inpatients.5.The extent of the PSD is heavier, the worse is cognitive function.