急性脑卒中 toastiii 型患者认知障碍筛查及其相关危险因素的研究-study on cognitive impairment screening and related risk factors of toast iii patients with acute stroke.docx

目录中文摘要············································································································1英文摘要···········································································································4研究论文急性脑卒中TOASTIII型患者认知障碍筛查及其相关危险因素的研究前言············································································································7材料与方法································································································9结果··········································································································15附图··········································································································17附表·········································································································25讨论··········································································································27结论··········································································································31参考文献·································································································32综述卒中后认知功能障碍的研究进展··························································38致谢··················································································································56个人简历··········································································································57急性脑卒中TOASTIII型患者认知障碍筛查及其相关危险因素的研究摘要目的：既往研究发现，急性卒中治疗Org10172试验（TrialofOrg10172inacutestroketreatment，TOAST）病因分型中的III型卒中（小动脉闭塞型/腔隙性脑梗死）更易发生卒中后认知功能障碍，然而临床上对TOASTIII型卒中的重视程度尚不足，分型过程中容易忽略不稳定性动脉粥样硬化斑块的存在，而与TOASTI型（大动脉粥样硬化型）产生混淆，并且卒中后认知功能障碍相关危险因素与急性脑卒中TOASTIII型患者认知功能障碍的关系目前尚无相关研究。因此，本研究拟利用高分辨率核磁黑血技术对动脉粥样硬化斑块进行评估，尽可能地对急性缺血性卒中TOASTIII型患者进行严格筛选，并针对筛选出的患者人群进行认知功能障碍评估，探寻已知卒中后认知功能障碍危险因素中哪些指标能够更敏感地预测急性脑卒中TOASTIII型患者发生认知障碍的可能性，从而帮助临床医生提高对急性脑卒中TOASTIII型患者是否伴随后期认知功能障碍进行早期诊断，及时进行有效治疗和预防。方法：1自2014年9月1日至2015年10月30日，连续收集河北医科大学第二医院神经内科入院的急性缺血性脑卒中患者。2通过常规头颅MRI扫描及高分辨率MRI对患者颅内病灶及颅内外动