调查脑卒中患者卒中后脑功能的状态，探索筛查卒中后脑功能的可行方式。

对104例收入首都医科大学宣武医院神经内科的急性脑卒中患者进行量表检查。从卒中后认知水平和卒中后情感状况两个方面评价卒中后患者的脑功能状态。选用简明精神状态量表（MMSE）和中文版蒙特利尔认知评估量表（MoCA）评价患者卒中后认知状态，选用汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评价患者卒中后情感状态，选用老年认知功能减退知情者问卷（IQCODE）作为卒中后认知功能障碍的初筛工具。通过非参数检验比较不同性别存在认知和情感异常评分的差异，按照MMSE评分正常和异常分为2组，采用χ²检验比较2组存在抑郁和焦虑的患者比例差异，采用独立样本t检验比较2组抑郁和焦虑评分的差异；采用独立样本t检验比较卒中后抑郁患者的焦虑评分和非抑郁患者的焦虑评分的差异。对部分患者进行IQCODE认知筛查量表测试，通过受试者工作特征曲线验证此筛查量表早期预测卒中后认知障碍的诊断效能。

本次研究纳入的104例患者中男性占76.92%，女性占23.08%。MMSE评价为认知异常的患者为38例（36.54%，38/104），依据HAMD及HAMA量表评价存在抑郁和焦虑症状的脑卒中患者各有47例（45.19%，47/104）。卒中后HAMA量表评分女性患者高于男性[11.5（10.0）分vs 7.0（9.0）分]，差异具有统计学意义（Z=-2.481，P=0.013），而MMSE、MoCA和HAMD评分男女之间差异均无统计学意义（P均＞0.05）。抑郁患者比例和抑郁评分认知异常组高于认知正常组[23（60.53%）vs 24（36.36%）；（9.08±6.15）分vs（5.95±4.78）分]，差异具有统计学意义（χ²=5.684，P=0.017；t=2.89，P=0.005）；焦虑评分认知异常组高于认知正常组[（10.53±6.03）分vs（6.95±5.77）分]，差异具有统计学意义（t=2.99，P=0.003）。卒中后抑郁患者的焦虑评分高于非抑郁患者的焦虑评分[（12.09±5.92）分vs（5.11±4.12）分]，差异具有统计学意义（t=7.067，P＜0.001）。受试者工作特征曲线分析IQCODE预测卒中后认知障碍的敏感度为72.22%，特异度为72.00%，曲线下面积为0.762。

脑卒中后，患者普遍存在认知障碍及情感障碍的脑功能变化。认知障碍普遍存在，情感障碍方面以焦虑状态更为突出，但常与抑郁伴发，IQCODE可用于初步筛查卒中后认知障碍。

To investigate the state of brain function in post-stroke patients, and explore possible measurements to screen brain function after stroke.

Scale examination was performed on 104 patients with acute strokes who were admitted to the Department of Neurology, Xuanwu Hospital of Capital Medical University. The post-stroke cognition level and post-stroke emotional state were used to evaluate the brain function status of post-stroke patients. The concise mental state scale (MMSE) and the Chinese version of the Montreal Cognitive Assessment Scale (MoCA) were used to evaluate the post-stroke cognitive state, and the Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the post-stroke emotions. For the status, the IQCODE questionnaire for elderly cognitive impairment was selected as the initial screening tool for cognitive dysfunction after stroke. Non-parametric tests were used to compare the differences in the proportion of patients with cognitive and emotional abnormalities in different genders. The χ² test and t test were used to compare the differences of discrete and continuous variables between groups, respectively. The IQCODE recognition screening scale was performed on some patients, and the diagnostic efficacy of it in early prediction of post-stroke cognitive impairment was evaluated by the receiver operating characteristic curve.

Among the 104 patients included in this study, males accounted for 76.92% and females for 23.08%. There were 38 patients (36.54%, 38/104) evaluated by MMSE as cognitive abnormalities. According to HAMD and HAMA scales, there were 47 patients (45.19%, 47/104) with stroke and depression symptoms. The score of female patients with anxiety assessed by the HAMA scale after stroke is higher than that of males [11.5 (10.0) vs 7.0 (9.0)], the difference is statistically significant (Z=-2.481, P=0.013), while by MMSE, MoCA and HAMD, there was no statistically significant difference in the score between male and female (P＞0.05). The proportion of patients with depression and depression scores in the cognitively abnormal group were higher than the cognitively normal group [23(60.53%) vs 24(36.36%); (9.08±6.15)points vs (5.95±4.78)points], the differences were statistically significant (χ²=5.684, P=0.017; t=2.89, P=0.005); the cognitive anomaly group with anxiety score is higher than the normal cognitive group [(10.53±6.03) points vs (6.95±5.77) points], the differences are statistically significant (t=2.99, P=0.003). The difference between the anxiety scores of post-stroke depression patients and non-depression patients was statistically significant [(12.09±5.92) vs (5.11±4.12); t=7.067, P＜0.001]. Receiver operating characteristic curve analysis of IQCODE can be used to predict post-stroke cognitive impairment with the sensitivity of 72.22%, the specificity of 72.00%, and an area under the curve of 0.762.

After stroke, patients often have cognitive and emotional disorders of brain function. Cognitive disorders are common, and anxiety is more prominent in emotional disorders, but it is often accompanied by depression. IQCODE can be used to preliminary screening for post-stroke cognitive disorders.