Study On The Relationship Between Routine Examinations Of The Patients With Ischemic Stroke And Cognitive Impairment

Objective:To explore the value of routine examination in patients with vascular cognitive impairment (VCI) after ischemic stroke, so as to build up a clinical pathway to diagnose VCI.Methods:177patients with both his/her age being over60and post ischemic stroke3month were involved in this study. All subjects had accepted the following neuropsychological assessments:Montreal Cognitive Assessment-Changsha version, Mini-Mental State Examination, Frontal Assessment Battery, Clinical Dementia Rating (CDR), Activity of Daily Living Scale (ADL), Center for Epidemiological Survey (CES-D), etc. The criteria of diagnosis were as following:the NINDS-AIREN criteria and expert opinion of Vascular Cognitive Impairment Working Group. Additionally, collection the demographic dates and medical history, the results of blood routine examinations, carotid color duplex ultrasonography and neuroimaging, and then use the chi-square test, one-way ANOVA and receiver operating characteristic to evaluate the above variables diagnosis value in post ischemic stroke cognitive impairment, and to build up a clinical pathway to diagnose VCI. Results:1. The VCI distribution of patients with ischemic stroke was significantly different with age and educational level, but not significantly different with gender.2. The VCI distribution of patients with ischemic stroke was significantly different with hypertension, hyperlipidaemia and chronic obstructive pulmonary disease.3. It was statistically significant that the result of white blood cell count, platelet count, aspartate aminotransferase, albumin, blood sugar, total cholesterol and low density lipoprotein among the patients with ischemic stroke in cognitive normal group, VCIND group and VD group, and the rest results of routine examination have no significant difference.4. It was statistically significant that the results of carotid color duplex ultrasonography among the patients with ischemic stroke in cognitive normal group, VCIND group and VD group.5. The difference was statistically different in the occurrence of white matter, left frontal lobe, left parietal lobe, temporal lobe, capsula interna, thalamus, cerebellum infarction among the patients with ischemic stroke in cognitive normal group, VCIND group and VD group.Conclusions:1. Age, low education level, hypertension, hyperlipidaemia and chronic obstructive pulmonary disease were risk factors of VCI after ischemic stroke.2. Blood routine test, liver function test, blood sugar test and blood lipids test have a certain value in diagnosis of VCI after ischemic stroke.3. Carotid color duplex ultrasonography and neuroimaging have a certain value in diagnosis of causes of VCI after ischemic stroke.4. The pathway of clinical diagnosis for PISCI:screening for high-risk groups at the early stage, dynamically monitoring the related indicators of VCI risk factors, using neuropsychological assessment to diagnose the suspicious patients.