Impact of early refined nursing program on prognosis of middle-aged and elderly patients with cognitive dysfunction combined with cerebral infarction

IF 3.9 4区医学 Q1 PSYCHIATRY

World Journal of Psychiatry Pub Date : 2024-07-19 DOI:10.5498/wjp.v14.i7.1034

Hui-Lian Xiong, Zhi-Xin Li, Xin Lu, Yan-Hua Lu, Ping Zhong

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引用次数: 0

Abstract

BACKGROUND Cerebral infarction is a local or extensive necrosis of brain tissue. Subsequently, the corresponding neurological deficits appear. The incidence of cerebrovascular diseases in China is increasing gradually. After the onset of cerebrovascular disease, the most common sequelae include movement disorders, language disorders, and cognitive dysfunction. AIM To investigate the effect of early refined nursing program on the prognosis of middle-aged and elderly patients with cerebral infarction combined with cognitive dysfunction. METHODS A retrospective study was conducted to divide 60 patients with cerebral infarction and cognitive impairment into an experimental group (n = 32) and a control group (n = 28). The experimental group received early intensive care every day, and the control group received daily routine care. The scores of the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT), as well as the latency and amplitude of the event-related potential P300, were used as main indicators to evaluate changes in cognitive function, and changes in BDNF, TGF-β, and GDNF expression were used as secondary indicators. RESULTS Both groups experienced notable enhancements in MMSE scores, with the experimental group demonstrating higher scores than the control group (experimental: 28.75 ± 2.31; control: 25.84 ± 2.87). Moreover, reductions in TMT-A and TMT-B scores were observed in both groups (experimental: TMT-A 52.36 ± 6.18, TMT-B 98.47 ± 10.23; control: TMT-A 61.48 ± 7.92, TMT-B 112.63 ± 12.55), with the experimental group displaying lower scores. P300 Latency decreased (experimental: 270.63 ms ± 14.28 ms; control: 285.72 ms ± 16.45 ms), while amplitude increased (experimental: 7.82 μV ± 1.05 μV; control: 6.35 μV ± 0.98 μV) significantly in both groups, with superior outcomes in the experimental cohort. Additionally, the levels of the growth factors BDNF, TGF-β1, and GDNF surged (experimental: BDNF 48.37 ng/mL ± 5.62 ng/mL, TGF-β1 52.14 pg/mL ± 4.28 pg/mL, GDNF 34.76 ng/mL ± 3.89 ng/mL; control: BDNF 42.58 ng/mL ± 4.73 ng/mL, TGF-β1 46.23 pg/mL ± 3.94 pg/mL, GDNF 30.25 ng/mL ± 2.98 ng/mL) in both groups, with higher levels in the experimental group. CONCLUSION For middle-aged and elderly patients with cerebral infarction and cognitive dysfunction, early refined nursing can significantly improve their cognitive function and prognosis.

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早期精细化护理方案对中老年认知功能障碍合并脑梗死患者预后的影响

背景脑梗塞是脑组织局部或大面积坏死。随后出现相应的神经功能缺损。脑血管疾病在中国的发病率逐渐上升。脑血管病发病后，最常见的后遗症包括运动障碍、语言障碍和认知功能障碍。目的探讨早期精细化护理方案对中老年脑梗死合并认知功能障碍患者预后的影响。方法采用回顾性研究方法，将 60 例脑梗死合并认知障碍患者分为实验组（32 例）和对照组（28 例）。实验组每天接受早期强化护理，对照组每天接受常规护理。以迷你精神状态检查（MMSE）和寻迹测试（TMT）的得分以及事件相关电位 P300 的潜伏期和振幅作为主要指标来评估认知功能的变化，以 BDNF、TGF-β 和 GDNF 表达的变化作为次要指标。结果两组患者的 MMSE 评分均有显著提高，实验组高于对照组（实验组：28.75 ± 2.31；对照组：25.84 ± 2.87）。此外，两组的 TMT-A 和 TMT-B 分数均有所降低（实验组：TMT-A 52.36 ± 6.18，TMT-B 98.47 ± 10.23；对照组：TMT-A 61.48 ± 7.18，TMT-B 98.47 ± 10.23）：TMT-A 61.48 ± 7.92，TMT-B 112.63 ± 12.55），实验组得分更低。两组的 P300 潜伏期均显著下降（实验组：270.63 ms ± 14.28 ms；对照组：285.72 ms ± 16.45 ms），而振幅则显著增加（实验组：7.82 μV ± 1.05 μV；对照组：6.35 μV ± 0.98 μV），实验组的结果更优。此外，生长因子 BDNF、TGF-β1 和 GDNF 水平激增（实验组：BDNF 48.37 ng/mL ± 5.62 ng/mL，TGF-β1 52.14 pg/mL ± 4.28 pg/mL，GDNF 34.76 ng/mL ± 3.89 ng/mL；对照组：BDNF 42.58 ng/mL ± 5.62 ng/mL，TGF-β1 52.14 pg/mL ± 4.28 pg/mL，GDNF 34.76 ng/mL ± 3.89 ng/mL）：BDNF 42.58 ng/mL ± 4.73 ng/mL，TGF-β1 46.23 pg/mL ± 3.94 pg/mL，GDNF 30.25 ng/mL ± 2.98 ng/mL），其中实验组水平更高。结论对于中老年脑梗死认知功能障碍患者，早期精细化护理可明显改善其认知功能和预后。

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来源期刊

World Journal of Psychiatry PSYCHIATRY-

自引率

6.50%

发文量

110

期刊介绍： The World Journal of Psychiatry (WJP) is a high-quality, peer reviewed, open-access journal. The primary task of WJP is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of psychiatry. In order to promote productive academic communication, the peer review process for the WJP is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJP are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in psychiatry.