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ОСОБЕННОСТИ ПОСТИНСУЛЬТНЫХ КОГНИТИВНЫХ НАРУШЕНИЙ У ПАЦИЕНТОВ С МЕТАБОЛИЧЕСКИМ СИНДРОМОМ

ОСОБЕННОСТИ ПОСТИНСУЛЬТНЫХ КОГНИТИВНЫХ НАРУШЕНИЙ У ПАЦИЕНТОВ С МЕТАБОЛИЧЕСКИМ СИНДРОМОМ

Abstract

Цель исследования: определить частоту умеренных пост-инсультных когнитивных нарушений (ПИКН) и постинсультной деменции (ПД) у больных с метаболическим синдромом (МС) и без такового, которые перенесли ишемический или геморрагический инсульт; определить влияние демографических, сосудистых факторов риска, нейровизуализационных характеристик инсульта на тяжесть ПИКН у больных с МС; оценить динамику восстановления когнитивных функций у пациентов с ПИКН с МС и без такового. В исследование включили 132 больных в возрасте от 45 до 84 лет, которые перенесли инсульт в сроки от 3 до 6 месяцев тому назад. Пациентов разделили на две группы: основную (с МС) и контрольную (без МС), а также на 3 возрастных подгруппы: 45-59 средний возраст, 60-74 пожилой возраст, 75-89 лет стареческий возраст. Степень когнитивных нарушений оценивали при помощи краткой шкалы оценки психического статуса (Mini-Mental State Examination). Дополнительно использовали: методику заучивания 10 слов, тест заучивання парных взаимосвязанных слов (The Paired Associates Learning Test), таблицы Шульте, тест цветово-словесного взаимодействия (the Stroop Color-Word Interference Test/SСWT), тест рисования часов. У пациентов с МС после перенесенного инсульта достоверно чаще определяли мягкую и выраженную деменцию, в то время как в контрольной группе значительно чаще встречались легкие ПИКН. Определили достоверное влияние возраста на выраженность ПИКН, особенно у пациентов с МС: с увеличением возраста в обеих клинических группах больных нарастала тяжесть ПИКН, однако достоверно более выраженными ПИКН были у пациентов с МС пожилого и старческого возраста. Достоверно влияли на тяжесть ПИКН у больных с МС: очаги ишемии большого размера в каротидном бассейне в доминантном полушарии головного мозга, гемодинамический тип инсульта, а также наличие «немых» очагов ишемии. По результатам нейропсихологических тестов, достоверно лучше восстановились когнитивные функции через 3 месяца после инсульта у больных без МС

The aim of the study was to establish the frequency of moderate post-stroke cognitive impairments (PSCI) and post-stroke dementia (PSD) in patients with metabolic syndrome (MS) and without it, who had ischemic or hemorrhagic stroke; influence of demographic, vascular risk factors, neuroimaging characteristics of stroke on the severity of PSCI in patients with MS; to evaluate the dynamics of improvement of cognitive functions in patients with PSCI with MS and without it. There were 132 patients aged from 45 to 84 years enrolled into the study, with ischemic or hemorrhagic stroke from 3 to 6 months ago. All patients were divided into two groups: main (with MS) and control (without it). Also all the patients were devided into three age subgroups: 45-59 middle aged, 60-74 elderly, 75-89 years old. Cognitive assessments included general cognition (Mini-Mental State Examination), memory (verbal learning test, the Paired Associates Learning Test), rate of sense-motor reactions and information processing speed (Schulte tables), the Stroop Color-Word Interference Test/SСWT, clock drawing test. Mild and moderate dementia was significantly more frequent in patients with MS after stroke, while mild PSCI was significantly more frequent in patients of the control group. Age of the patients influenced significantly on the severity of PSCI, especially in patients with MS: the most severe PSCI was in old and elderly patients. Large size infarctions in the distribution of left or right carotid arteries and dominant hemispheric lesions, hemodynamic type of stroke, presence of silent lesions on the MRI influenced significantly on the severity of PSCI. According to the results of neuropsychological testing significantly better improvement of cognitive functions at 3 months after stroke was observed in patients without MS

Keywords

ПОСТИНСУЛЬТНЫЕ КОГНИТИВНЫЕ НАРУШЕНИЯ,POST-STROKE COGNITIVE IMPAIRMENTS,ПОСТ-ИНСУЛЬТНАЯ ДЕМЕНЦИЯ,POST-STROKE DEMENTIA,МЕТАБОЛИЧЕСКИЙ СИНДРОМ,METABOLIC SYNDROME,ПОСТіНСУЛЬТНі КОГНіТИВНі ПОРУШЕННЯ,ПОСТіНСУЛЬТНА ДЕМЕНЦіЯ,МЕТАБОЛіЧНИЙ СИНДРОМ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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