基于纵向研究的出血性脑卒中恢复期病人记忆与执行功能的轨迹分析

    Longitudinal trajectory analysis of memory and executive function in patients with hemorrhagic stroke during the recovery phase

    • 摘要: 目的:基于纵向研究分析出血性脑卒中恢复期病人记忆与执行功能的症状轨迹,识别不同潜在亚群,并探讨其影响因素,为制定个体化康复方案提供科学依据。方法:采用简单随机抽样法选取136例出血性脑卒中病人作为研究对象。使用一般资料问卷、记忆与执行筛查量表、社会支持量表进行调查。采用潜变量增长混合模型分析病人记忆与执行功能的发展轨迹,并通过单因素分析和logistic回归分析识别影响轨迹的预测因素。结果:出血性脑卒中恢复期的记忆与执行功能恢复轨迹可分为高水平记忆与执行能力组和低水平记忆与执行能力组。高水平记忆与执行能力组病人在恢复期内表现出较为稳定且较高的记忆和执行能力,而低水平记忆与执行能力组病人则恢复缓慢,甚至可能持续处于较低水平。多因素logistic结果显示,脑出血家族史、合并慢性病、具有吸烟史是趋于低水平记忆与执行能力的危险因素(P<0.05~P<0.01),文化程度高中及以上、接受康复治疗、社会支持得分是趋于高水平记忆与执行能力的保护因素(P<0.01)。结论:出血性脑卒中恢复期病人的记忆与执行功能恢复轨迹可分为高水平与低水平2种不同轨迹,文化程度高、高社会支持、接受康复治疗有利于记忆与执行功能的恢复,脑出血家族史、合并慢性病、吸烟史不利于记忆与执行功能的恢复,可结合上述影响因素制定干预措施提高病人记忆与执行功能。

       

      Abstract: Objective: To analyze the symptom trajectory of memory and executive function in patients with hemorrhagic stroke during the recovery phase based on longitudinal study,identify different latent subgroups,and explore their influencing factors,so as to provide a scientific basis for developing individualized rehabilitation protocols. Methods: A total of 136 patients with hemorrhagic stroke were selected as the study subjects using simple random sampling method.General information questionnaire,memory and executive screening scale,and social support rating scale were used for investigation.Latent growth mixture model was employed to analyze the developmental trajectory of patients' memory and executive function,and univariate analysis and logistic regression analysis were used to identify predictive factors affecting the trajectory. Results: The recovery trajectory of memory and executive function in the recovery phase of hemorrhagic stroke could be divided into high-level memory and executive ability group,and low-level memory and executive ability group.Patients in the high-level memory and executive ability group exhibited relatively stable and high memory and executive ability during the recovery phase,while patients in the low-level memory and executive ability group recovered slowly and might even persist at a lower level.Multivariate logistic regression results indicated that family history of cerebral hemorrhage,combined chronic diseases,and smoking history were risk factors for the low-level memory and executive ability (P<0.05 to P<0.01).Educational level of high school or above,receiving rehabilitation therapy,and social support scores were protective factors for the high-level memory and executive ability (P<0.01). Conclusions: The recovery trajectory of memory and executive function in patients with hemorrhagic stroke during the recovery phase can be divided into high-level trajectory and low-level trajectory.High educational level,high social support,and receiving rehabilitation therapy are beneficial to the recovery of memory and executive function.Family history of cerebral hemorrhage,combined chronic diseases,and smoking history are not conducive to the recovery of memory and executive function.Intervention measures can be developed based on the above influencing factors to improve patients' memory and executive function.

       

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