卒中后认知障碍的相关危险因素及治疗的研究进展
Research Progress on Risk Factors and Treatment Related to Cognitive Impairment after Stroke
DOI: 10.12677/ACM.2023.1392042, PDF,   
作者: 张璐媛：青海大学研究生院神经病学，青海 西宁；杨晓莉*：青海省人民医院神经病学，青海 西宁
关键词: 脑卒中；卒中后认知障碍；危险因素；治疗；Stroke； Cognitive Impairment after Stroke； Risk Factors； Treatment
摘要: 卒中后认知障碍(post-stroke cognitive impairment, PSCI)是指在脑卒中后6个月内出现达到认知障碍诊断标准的一系列综合征，是脑卒中的主要并发症之一，影响超过三分之一的脑卒中患者，不仅影响脑卒中后患者的生活质量，也影响患者对治疗方案的依从性，威胁他们的生活质量并增加残疾和死亡的风险。其影响因素众多，这篇综述就PSCI的发病机制、危险因素和治疗方法进行概述。主要包括：年龄、教育程度、经济收入、血压、血糖等对PSCI的影响及目前常见的治疗方法。为PSCI的早期诊断及预防提供思路。
Abstract: Post-stroke cognitive impairment (PSCI) refers to a series of syndromes that meet the diagnostic criteria for cognitive impairment within 6 months after stroke, and is one of the main complications of stroke, affecting more than one-third of stroke patients, not only affecting the quality of life of pa-tients after stroke, but also affecting patients’ adherence to treatment plans, threatening their quality of life and increasing the risk of disability and death. There are many factors influencing it, and this review provides an overview of the pathogenesis, risk factors, and treatment of PSCI. It mainly includes the impact of age, education, economic income, blood pressure, blood sugar, etc., on PSCI and the current common treatments. To provide ideas for the early diagnosis and prevention of PSCI.
文章引用：张璐媛, 杨晓莉. 卒中后认知障碍的相关危险因素及治疗的研究进展[J]. 临床医学进展, 2023, 13(9): 14606-14611. https://doi.org/10.12677/ACM.2023.1392042

参考文献

[1] Feigin, V.L., Brainin, M., Norrving, B., et al. (2022) World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. International Journal of Stroke, 17, 18-29. [Google Scholar] [CrossRef] [PubMed]
[2] Lee, K.P., Chen, J.S. and Wang, C.Y. (2023) Association between Diabetes Mellitus and Post-Stroke Cognitive Impairment. Journal of Dia-betes Investigation, 14, 6-11. [Google Scholar] [CrossRef] [PubMed]
[3] Safiri, S., Kolahi, A.A., Hoy, D., et al. (2019) Global, Regional and National Burden of Rheumatoid Arthritis 1990-2017: A Systematic Analysis of the Global Burden of Disease Study 2017. Annals of the Rheumatic Diseases, 78, 1463-1471. [Google Scholar] [CrossRef] [PubMed]
[4] Mijajlović, M.D., Pavlović, A., Brainin, M., et al. (2017) Post-Stroke Dementia—A Comprehensive Review. BMC Medicine, 15, Article No. 11. [Google Scholar] [CrossRef] [PubMed]
[5] Zhang, M.S., Liang, J.H., Yang, M.J., et al. (2022) Low Serum Superoxide Dismutase Is Associated with a High Risk of Cognitive Impairment after Mild Acute Ischemic Stroke. Fron-tiers in Aging Neuroscience, 14, Article ID: 834114. [Google Scholar] [CrossRef] [PubMed]
[6] Kim, S.Y., Chae, C.W., Lee, H.J., et al. (2020) Sodium Butyrate Inhibits High Cholesterol-Induced Neuronal Amyloidogenesis by Modulating NRF2 Stabilization-Mediated ROS Levels: Involvement of NOX2 and SOD1. Cell Death & Disease, 11, Article No. 469. [Google Scholar] [CrossRef] [PubMed]
[7] Hyun, Y.M. and Hong, C.W. (2017) Deep Insight into Neutrophil Trafficking in Various Organs. Journal of Leukocyte Biology, 102, 617-629. [Google Scholar] [CrossRef] 
[8] Huang, Y., Li, F., Chen, Z., et al. (2021) Predictive Value of Degranulating Factors of Neutrophils in Massive Cerebral Infarction. Cell Transplantation, 30, 1-9. [Google Scholar] [CrossRef] [PubMed]
[9] Shang, T., Ma, B., Shen, Y., et al. (2022) High Neutrophil Per-centage and Neutrophil-Lymphocyte Ratio in Acute Phase of Ischemic Stroke Predict Cognitive Impairment: A Sin-gle-Center Retrospective Study in China. Frontiers in Neurology, 13, Article ID: 907486. [Google Scholar] [CrossRef] [PubMed]
[10] Molad, J., Hallevi, H., Korczyn, A.D., et al. (2019) Vascular and Neurodegenerative Markers for the Prediction of Post-Stroke Cognitive Impairment: Results from the TABASCO Study. Journal of Alzheimer’s Disease, 70, 889-898. [Google Scholar] [CrossRef] 
[11] Tong, Z., Wang, W., Luo, W., et al. (2017) Urine Formaldehyde Predicts Cognitive Impairment in Post-Stroke Dementia and Alzheimer’s Disease. Journal of Alzheimer’s Disease, 55, 1031-1038. [Google Scholar] [CrossRef] 
[12] Cheignon, C., Tomas, M., Bonnefont-Rousselot, D., et al. (2018) Oxida-tive Stress and the Amyloid Beta Peptide in Alzheimer’s Disease. Redox Biology, 14, 450-464. [Google Scholar] [CrossRef] [PubMed]
[13] Yu, C.C., Wang, Y., Shen, F., et al. (2018) High-Frequency (50 Hz) Electroacupuncture Ameliorates Cognitive Impairment in Rats with Amyloid Beta 1-42-Induced Alzheimer’s Disease. Neural Regeneration Research, 13, 1833-1841. [Google Scholar] [CrossRef] [PubMed]
[14] Martins, A.H., Zayas-Santiago, A., Ferrer-Acosta, Y., et al. (2019) Accumulation of Amyloid Beta (Aβ) Peptide on Blood Vessel Walls in the Damaged Brain after Transient Middle Cerebral Artery Occlusion. Biomolecules, 9, Article No. 350. [Google Scholar] [CrossRef] [PubMed]
[15] Goulay, R., Mena Romo, L., Hol, E.M., et al. (2020) From Stroke to Dementia: A Comprehensive Review Exposing Tight Interactions between Stroke and Amyloid-β Formation. Transla-tional Stroke Research, 11, 601-614. [Google Scholar] [CrossRef] [PubMed]
[16] Moulin, S., Leys, D., Schraen-Maschke, S., et al. (2017) Aβ1-40 and Aβ1-42 Plasmatic Levels in Stroke: Influence of Pre-Existing Cognitive Status and Stroke Characteristics. Current Alzheimer Research, 14, 686-694. [Google Scholar] [CrossRef] [PubMed]
[17] Díaz-Venegas, C., Samper-Ternent, R., Michaels-Obregón, A., et al. (2019) The Effect of Educational Attainment on Cognition of Older Adults: Results from the Mexican Health and Aging Study 2001 and 2012. Aging & Mental Health, 23, 1586-1594. [Google Scholar] [CrossRef] [PubMed]
[18] He, A., Wang, Z., Wu, X., et al. (2023) Incidence of Post-Stroke Cognitive Impairment in Patients with First-Ever Ischemic Stroke: A Multicenter Cross-Sectional Study in China. The Lancet Regional Health—Western Pacific, 33, Article ID: 100687. [Google Scholar] [CrossRef] [PubMed]
[19] Lee, K.P., Chang, A.Y.W. and Sung, P.S. (2021) Association between Blood Pressure, Blood Pressure Variability, and Post-Stroke Cognitive Impairment. Biomedicines, 9, Article No. 773. [Google Scholar] [CrossRef] [PubMed]
[20] Li, H., Sun, D., Lu, D., et al. (2020) Low Hippocampal Dentate Gyrus Volume Associated with Hypertension-Related Cognitive Impairment. American Journal of Alzheimer’s Disease and other Dementias®, 35, 1-8. [Google Scholar] [CrossRef] [PubMed]
[21] Feng, R., Rolls, E.T., Cheng, W., et al. (2020) Hypertension Is Associated with Reduced Hippocampal Connectivity and Impaired Memory. EBioMedicine, 61, Article ID: 103082. [Google Scholar] [CrossRef] [PubMed]
[22] van Middelaar, T., Argillander, T.E., Schreuder, F., et al. (2018) Effect of Antihypertensive Medication on Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis. Stroke, 49, 1531-1533. [Google Scholar] [CrossRef] 
[23] Huang, Y.Y., Chen, S.D., Leng, X.Y., et al. (2022) Post-Stroke Cognitive Impairment: Epidemiology, Risk Factors, and Management. Journal of Alzheimer’s Disease, 86, 983-999. [Google Scholar] [CrossRef] 
[24] Ahmed, H.A., Ishrat, T., Pillai, B., et al. (2018) RAS Modula-tion Prevents Progressive Cognitive Impairment after Experimental Stroke: A Randomized, Blinded Preclinical Trial. Journal of Neuroinflammation, 15, Article No. 229. [Google Scholar] [CrossRef] [PubMed]
[25] Jackson, L., Dong, G., Althomali, W., et al. (2020) Delayed Ad-ministration of Angiotensin II Type 2 Receptor (AT2R) Agonist Compound 21 Prevents the Development of Post-Stroke Cognitive Impairment in Diabetes through the Modulation of Microglia Polarization. Translational Stroke Research, 11, 762-775. [Google Scholar] [CrossRef] [PubMed]
[26] Saavedra, J.M. (2021) Angiotensin Receptor Blockers Are Not Just for Hypertension Anymore. Physiology (Bethesda), 36, 160-173. [Google Scholar] [CrossRef] [PubMed]
[27] Barić, A. and Dobrivojević Radmilović, M. (2021) Microglia and Bradykinin cross Talk in Poststroke Cognitive Impairment in Diabetes. The American Journal of Physiology-Cell Physi-ology, 320, C613-C618. [Google Scholar] [CrossRef] [PubMed]
[28] Chen, C., Wu, S., Hong, Z., et al. (2019) Chronic Hyperglycemia Regulates Microglia Polarization through ERK5. Aging (Albany NY), 11, 697-706. [Google Scholar] [CrossRef] [PubMed]
[29] Jackson, L., Li, W., Abdul, Y., et al. (2019) Diabetic Stroke Promotes a Sexually Dimorphic Expansion of T Cells. NeuroMolecular Medicine, 21, 445-453. [Google Scholar] [CrossRef] [PubMed]
[30] Wang, H., Zhang, M., Li, J., et al. (2022) Gut Microbiota Is Causally Associated with Poststroke Cognitive Impairment through Lipopolysaccharide and Butyrate. Journal of Neu-roinflammation, 19, Article No. 76. [Google Scholar] [CrossRef] [PubMed]
[31] Oberlin, L.E., Waiwood, A.M., Cumming, T.B., et al. (2017) Effects of Physical Activity on Poststroke Cognitive Function: A Meta-Analysis of Randomized Controlled Trials. Stroke, 48, 3093-3100. [Google Scholar] [CrossRef] 
[32] Sun, R., Li, X., Zhu, Z., et al. (2021) Effects of Combined Cognitive and Exercise Interventions on Poststroke Cognitive Function: A Systematic Review and Meta-Analysis. Bio-Med Research International, 2021, Article ID: 4558279. [Google Scholar] [CrossRef] [PubMed]
[33] Ding, M.Y., Xu, Y., Wang, Y.Z., et al. (2019) Predictors of Cognitive Impairment after Stroke: A Prospective Stroke Cohort Study. Journal of Alzheimer’s Disease, 71, 1139-1151. [Google Scholar] [CrossRef] 
[34] 汪凯, 董强, 郁金泰, 等. 卒中后认知障碍管理专家共识2021[J]. 中国卒中杂志, 2021, 16(4): 376-389.
[35] Chelluboina, B. and Vemuganti, R. (2019) Chronic Kidney Disease in the Pathogenesis of Acute Ischemic Stroke. Journal of Cerebral Blood Flow & Metabolism, 39, 1893-1905. [Google Scholar] [CrossRef] 
[36] Rost, N.S., Meschia, J.F., Gottesman, R., et al. (2021) Cognitive Impairment and Dementia after Stroke: Design and Rationale for the Discovery Study. Stroke, 52, e499-e516. [Google Scholar] [CrossRef] 
[37] Mehta, U.M., Naik, S.S., Thanki, M.V., et al. (2019) In-vestigational and Therapeutic Applications of Transcranial Magnetic Stimulation in Schizophrenia. Current Psychiatry Reports, 21, Article No. 89. [Google Scholar] [CrossRef] [PubMed]
[38] Blech, B. and Starling, A.J. (2020) Noninvasive Neuromodulation in Migraine. Current Pain and Headache Reports, 24, Article No. 78. [Google Scholar] [CrossRef] [PubMed]
[39] Chung, C.L., Mak, M.K., Hallett, M. (2020) Transcranial Mag-netic Stimulation Promotes Gait Training in Parkinson Disease. Annals of Neurology, 88, 933-945. [Google Scholar] [CrossRef] [PubMed]
[40] Mimura, Y., Nishida, H., Nakajima, S., et al. (2021) Neurophysiological Biomarkers Using Transcranial Magnetic Stimulation in Alzheimer’s Disease and Mild Cognitive Impairment: A Sys-tematic Review and Meta-Analysis. Neuroscience & Biobehavioral Reviews, 121, 47-59. [Google Scholar] [CrossRef] [PubMed]
[41] Gong, C., Hu, H., Peng, X.M., et al. (2023) Therapeutic Ef-fects of Repetitive Transcranial Magnetic Stimulation on Cognitive Impairment in Stroke Patients: A Systematic Review and Meta-Analysis. Frontiers in Human Neuroscience, 17, Article ID: 1177594. [Google Scholar] [CrossRef] [PubMed]

为你推荐