创伤性脑损伤病人认知储备与认知障碍的关系

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Study on the relationship between cognitive reserve and cognitive impairment in patients with traumatic brain injury

LUO Sixiong'， XU Yi²，ZHU Xiaoju'， ZHANG Guanghui³，FENG Xianhong4，WANG Zonghual* 1.School of Nursing，Army Medical University， Chongqing 40o38 China;2.Chongqing Normal University; 3.The First Afiliated Hospital of Army Medical University;4.Chongqing Nursing School *Corresponding Author WANG Zonghua，E-mail： zonghua91o@ tmmu.edu.cn

AbstractObjective：Toexploretherelationshipbetweencognitivereserveandtheriskofcognitiveimpairmentaftertraumatic brain injuryMethods：From September223toAugust20，2O24，patientswithTBIwhowerehospitalizedinthedepartmentofneurosurgery oremergencymedicineinertiarygradeAhospitalsinChongqingcitywereselectedbyconveniencesamplingmethodtoconductacrosectionalinvestigationGeneraliformationasbtaindbyospitalizationoredsideasessment.Cognitiveeservelevelandcgiie functionwereasessedbytheCognitiveReserveIndex QuestionnaireandtheMontrealCognitiveAssessmentScale，respectivelyThe incidenceofcognitiveimpairmentatdiferentlevelsofcognitivereserve wasvisualizedbybarchart.Andthetrendchi-squaretestwas usedtoexplorewhethertherewasatrend.Restrictedcubicspline（RCS）modelwasusedtoanalyze therelationshipbetweencognitive reserveandtheriskofcognitiveimpairmentaftertraumaticbraininjuryLogisticregresionmodelwasusedtoanalyzethepredictive efectfcognitivereserveonognitiveimpairmentinpatientswithtraumaticbrainijuryResults：Atotalof4O8TBpatientsaged8-87 years wereinvestigatedThetotalscoreofCognitiveReserveIndexQuestioaireas91，94）.ThetotalsoreofMontrealCognitive Assessment Scale was 22（16，28）.And 246 cases （60.3% ）had cognitive impairment.The results of restricted cubic spline showed that therewasanegativelineardose-responserelationshipbetweencognitivereserveandtheriskofcognitiveimpairmentinhetotal population and gender stratigraphy P for overall <0.05，P for nonlinear>O.O5）.Logistic regression analysis and trend test results showed thatafteradjustingfoofoundingfctorsteiskofogitieimpaimentinthegenralopulatioandgndertratificatiodeased withtheincreaseofognitiveresere.Conclusions：Cognitivereservecouldbeanimportantpredictorofognitiveimpaimentinpatients withtraumaticbrainijury.Andimprovingcognitivereservelevelisexpectedtobeoneofthepotentialstrategiesforearlycognitive intervention.

Keywordstraumaticbraininjury;cognitiveimpairment;cognitivereserve;forecast;protectivefactor;restrictedcubicsplines

全世界每年有超过5000万人遭受创伤性脑损伤（traumaticbrain injury，TBI），发病率高达275/10万，发病率为 5%～30%[1] 。（剩余10401字）