| Objective:To investigate the incidence and related risk factors of apathy in patients with acute ischemic stroke.Methods:1.Collecting 100 patients who met the criteria for acute ischemic stroke in the first affiliated hospital of Southwest Medical University from July 2015 to July 2014.Selecting 50 cases of healthy physical examination or hospitalized patients as control group.There were no significant differences in age,sex,education level,smoking,alcohol abused between two groups.2.Evaluating apathy,depression and cognitive function of the acute ischemic stroke group and the control group with modified apathy evaluation scale(MAES),Hamilton Depression Scale 17-item version(HAMD-17)and Montreal cognitive assessment(MoCA)respectively.3.According to the MAES score,acute ischemic stroke patients were divided into apathy group and non-apathy group(MAES more than 14 points defined as apathy).The differences of general information,risk factors of cerebrovascular disease,sleeping time,uric acid,serum inflammatory markers,NIHSS score,MOCA score,HAMD score,mRs score and the lesion location were compared between the two groups.Differences which have statistical significance(P<0.05)went into the multi-factor analysis,using binary unconditional logistic regression analysis to study the factors that influence the results.Results:1.The incidence of 100 cases of acute ischemic stroke was 34%(34/100).The apathy rate of control group was 6%(3/50),the difference was statistically significant between the two groups(P<0.001).2.In acute ischemic stroke group,apathy alone incidence rate was 2 3.00%(23/100).Apathy concurrent with depression rate were 11.00%(11/100),and the depression incidence was 20.00%(20/100),including depression alone 9.00%(9/100).3.The average age of the apathy patients in acute ischemic group was 67.47±7.56 years old,of which 19 were male(55.90%),the mean education time was 4.59±3.53 years.Non-apathy group included 66 cases,mean age was 62.30±10.67 years old,male 35 cases(53%),average age 6.67±3.74 years,the difference between the two groups in age and years of education was statistically significant(P<0.01).4.15(44.12%)diabetic patients were found in acute ischemic stroke group,while 14 were found in non-apathy group(21.21%),the difference between the two groups was statistically significant(P<0.05).There was no significant difference between the two groups in hypertension,diabetes,coronary heart disease,atrial fibrillation,blood lipids,blood glucose,glycosylated hemoglobin,carotid plaque,sleeping time,uric acid and serum inflammatory markers.5.The average NIHSS score of Acute ischemic stroke with apathy group was 4.53±2.05,non-apathy group mean score was 3.30±1.81;The average score of MOCA was 21.50±4.41,while the non-apathy group mean score was 23.55±3.14;the average score of HAMD was 6.85±3.90,higher than non-aphathy group mean score which was 5.23±3.33,the comparison between the two groups was statistically significant(P<0.05).6.12 brainstem lesions cases were found in the acute ischemic stroke with apathy group,accounted for 35.29%;while 8 were found in non-apathy group,accounting for 12.12%.18 people were found multiple lesions in apathy group,accounting for 52.94%;non-apathy group of 20 people,accounting for 30.30%,the comparison between the two groups was statistically significant(P<0.05).7.Multivariate logistic regression analysis showed that acute ischemic stroke NIHSS score(OR:1.398,95%CI:1.044?1.873,P=0.025)and MOCA score(OR:0.819,95%CI:0.698 to.960,P=0.014),brainstem lesions(OR:8.281,95%CI:1.989 34.472,P=0.004)and multiple lesions(OR:3.920,95%CI:1.261 12.181,P=0.018)are related to apathy in the acute stage of ischemic stroke.Conclusions:1.Apathy is a common neuropsychiatric symptoms of acute ischemic stroke patients,can exist alone or coexist with depression.2.Apathy is more likely to occur in patients with acute ischemic stroke patients who are elder-ly or with lower educational level,diabetes,serious neurological deficits,cognitive impairment,depression,lesions in the brain stem and multiple lesions.3.Cognitive impairment,severity of neurological deficits,brainstem lesions and multiple lesions may be the risk factors of apathy after the occurrence of acute ischemic stroke. |
PDF Full Text Request