Study On Risk Factors And TCM Syndrome Of Mild Cognitive Impairment After Cerebral Infarction

Objects To explore the risk factors of mild cognitive impairment after cerebral infarction.To initially establish the rules for TCM main syndromes of mild cognitive impairmentafter cerebral infarction,investigate dynamic characteristics of TCM main syndromes of mild cognitive impairmentafter cerebral infarction,and lay a foundation for further study on diagnosis scale for TCM syndrome of mild cognitive impairmentafter cerebral infarction.Methods1 Retrospective study on cases selected from multi-centers,including hospitals in Beijing,Shandong,Hebei,Changchun,Xiamen and so on is selected.2323 cases were finally included in the study.Further more,the cases were divided into a group without cognitive impairment(Group N,1457 cases)and a group with mild cognitive impairment after cerebral infarction(Group M,866 cases)according to the level of cognitive dysfunction.866 cases with mild cognitive impairment after cerebral infarction during education or health promotion plan intervention for 6 months were anlysed.2 A data management plantform was established based on Browser /Server architecture.The data management plantform has the functions of data input,data output,data check and data management.Statistics was processed by SPSS20.0.Risk factors of mild cognitive impairment after cerebral infarctionwere explored by chi-square test,conditionallogistic regression.Factor analysis was constructed to extract syndrome factors by unsupervised clustering analysis method.Based on the outcome that correlation degree between syndrome factors by mutual information computed,syndromes were established.On the basis of it,distribution characteristics of mian syndromes were analysed,as well as correlation analysis.Results1 Every sub-item dysfunction of cognitive occurred in pantients with mild cognitive impairment after cerebral infarction.There sub-items,four sub-items or five sub-items dysfunction of cognitive were common,84.30%.Visuospatial / executive function,delayed recall,language,abstraction were damaged significantly.2 The result of multi-factors logistic regression analysis showed that,age,Hyperlipidaemia,moderate drinking red wine and surfing the internet are related to mild cognitive impairment after cerebral infarction.Risk factors for mild cognitive impairment after cerebral infarction include age(OR=1.207,95%CI: 1.107-1.317),Hyperlipidaemia(OR=1.273,95%CI:1.007-1.520).Pantients with cerebral infarction aged 66-80 prone to mild cognitive impairment.Moderate drinking red wine(20 ml per day)(OR=0.443,95%CI: 0.294-0.667),surfing the internet(60 minutes per day)(OR=0.669,95%CI: 0.496-0.903),walking exercise(37 minutes per day)(OR=0.596,95%CI: 0.415-0.854)are protective factors of mild cognitive impairment after cerebral infarction.2 Factor analysis extracted 6 syndrome factors: qi deficiency,yin deficiency,phlegm,blood stasis,yang deficiency,fire.After the correlation analysis between 6 syndrome factors above,fifteen syndromes were combined: qi deficiency and blood stasis syndrome phlegm obstruction and blood stasis syndrome,kidney deficiency and blood stasis syndrome,yin deficiency and fire syndrome,yang deficiency in spleen and kidney syndrome,yang deficiency and phlegm obstruction syndrome,yin deficiency and phlegm obstruction syndrome and so on.Five main syndromes were extracted because of the frequency: qi deficiency and blood stasis syndrome(22.75%),yang deficiency in spleen and kidney syndrome(15.24%),phlegm obstruction and blood stasis syndrome(14.90%),yin deficiency and fire syndrome(12.46%),kidney deficiency and blood stasis syndrome(8.43%).Five main syndromes change over time and illness.With aggravation,numbers of pantients with kidney deficiency and blood stasis syndrome(15.94%),yang deficiency in spleen and kidney syndrome(13.39%)increase.Yang deficiency in spleen and kidney syndrome,kidney deficiency and blood stasis syndromeare related to change of illness.Conclusions1 Every sub-item dysfunction of cognitive occurred in pantients with mild cognitive impairment after cerebral infarction.There sub-items,four sub-items or five sub-items dysfunction of cognitive were common.2 Age,Hyperlipidaemia are risk factors of cognitive impairment after cerebral infarction.Moderate drinking red wine(20 ml per day),surfing the Internet(60 minutes per day),fast walking exercise(37 minutes per day)were protective factors of mild cognitive impairment after cerebral infarction.3 The major syndrome factors of mild cognitive impairment after cerebral infarction are qi deficiency,yin deficiency,phlegm,blood stasis,yang deficiency,fire.4 Five main syndromes: qi deficiency and blood stasis,yang deficiency in spleen and kidney,phlegm obstruction and blood stasis,yin deficiency and fire,kidney deficiency and blood stasis.The change of 5 main syndromesis related to illness.