Investigation of vascular dementia in stroke patients and analysis of risk factors
Objective To investigate the occurrence of vascular dementia in stroke patients and analyze its risk factors.Methods Totally 80 stroke patients treated in the First Affiliated Hospital of Zhengzhou University from August 2021 to September 2023 were selected as research objects,and were divided according to whether the patients had vascular dementi-a or not,into a study group i.e vascular dementia group(44 cases)and a control group i.e.non-vascular dementia group(36 cases).The general data of the two groups of patients were analyzed by single factor analysis,and the statistically significant indicators in the single factor analysis were analyzed by multi-factor logistic regression analysis using SPSS 21.0 statistical software to find out the risk factors of vascular dementia in stroke patients.Results The proportion of pa-tients with age＞70 years old,diabetes mellitus,hypertension,smoking history,drinking history,multiple foci,basal ganglia and frontal lobe infarction in the study group were significantly higher than that of the control group(P＜0.05).Plasma levels of ho-mocysteine(Hey)in the study group(22.13±5.12)µmol/L were significantly higher than those of the control group(13.94±3.11)μmol/L.In the study group,serum brain-derived neurotrophic factor(BDNF)and vascular endothelial growth factor(VEGF)were detected The levels of factor,VEGF(221.24±18.22)ng/mL and(4.11±1.81)ng/mL were significantly lower than those of control group(P＜0.05).From the results of multi-factor logistic regression analysis,age＞70 years,diabetes mellitus,hypertension,smoking history,drinking history,multiple lesions,basal segment and frontal lobe infarction,elevated plasma Hcy level,and decreased serum BDNF and VEGF levels were all independent risk factors for vascular dementia in stroke patients(OR=7.264,4.677,8.532,3.356,3.526,2.226,2.946,10.352,3.124,13.154),the difference was statistically significant(P＜0.05).The specificity of plasma Hcy,serum BDNF,serum VEGF and combined detection for pancreatic cancer liver metastasis were 90.6％,85.1％,91.1％and 94.1％,respective-ly,and the sensitivity were:63.3％,70.1％,69.2％,84.2％.The combined prediction efficacy of the three was signifi-cantly improved,and the specificity was 94.1％,and the sensitivity was 84.2％.Conclusion The risk factors for vascular dementia in stroke patients include old age,diabetes,hypertension,smoking history,drinking history,multiple lesions,basal ganglia and frontal lobe infarction,elevated plasma Hcy level,decreased serum BDNF,VEGF level,etc.Clinical interven-tion and treatment of stroke patients can be carried out in advance according to the patient's age,lifestyle,underlying disea-ses and clinical characteristics,and close attention should be paid to the patient's biochemical indicators,such as the in-crease of plasma Hcy level,serum BDNF and VEGF level combined detection,etc.,so as to prevent or slow down the devel-opment of stroke to vascular dementia,which is worthy of clinical promotion.
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