锁骨下动脉狭窄患者的认知功能评估分析

Evaluation of cognitive function in patients with subclavian artery stenosis

目的初步评估、分析锁骨下动脉狭窄(SS)患者的认知功能。方法选取2019年5月至2022年4月首都医科大学附属北京世纪坛医院经血管造影检查确诊的108例SS患者(观察组),根据年龄、性别配对后选取108例同期体检者作为对照组,比较两组受试者的基线特征、认知功能[蒙特利尔认知评估量表(MoCA)、简易精神状态检查量表(MMSE)评分],以及观察组中不同程度SS患者的基线特征、认知功能。按照认知功能的不同将所有受试者分为下降组和正常组,分析认知功能下降的独立危险因素。结果观察组患者高血压、糖尿病、冠心病、高脂血症的患者比例及收缩压均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的MoCA、MMSE评分均低于对照组,且观察组重度患者的MoCA、MMSE评分均低于轻度患者,差异均有统计学意义(P﹤0.05)。单因素分析结果显示,正常组的年龄、收缩压、高血压患者比例、糖尿病患者比例、SS患者比例均低于下降组,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥60岁、高血压、糖尿病、收缩压≥140 mmHg、SS均是预测认知功能下降的独立危险因素(P﹤0.05)。结论SS与患者的认知功能下降有关,狭窄程度越重,患者的认知功能下降得越明显。

Objective To evaluate and analyze the cognitive function of patients with subclavian artery stenosis(SS).Method A total of 108 SS patients confirmed by angiography in Beijing Shijitan Hospital,Capital Medical University from May 2019 to April 2022 were selected as the observation group.The patients were matched according to age and sex,and 108 subjects in the same period were selected as the control group.The baseline characteristics and cognitive function[Montreal cognitive assessment scale(MoCA)and mini-mental state examination(MMSE)scores]of subjects in the observation group and the control group,and the baseline characteristics and cognitive function of patients with different degrees of SS in the observation group were compared.All subjects were divided into the decreased group and the normal group according to the different cognitive functions,the independent risk factors of cognitive function decline were analyzed.Result The systolic blood pressure,and the proportion of patients with hypertension,diabetes,coronary heart disease and hyperlipidemia in the observation group were higher than those in the control group(P<0.05).The MoCA and MMSE scores of the patients in the observation group were lower than those in the control group,and the MoCA and MMSE scores of the severe patients in the observation group were lower than those in the mild patients(P<0.05).The univariate analysis showed that the age,systolic blood pressure,the proportion of patients with hypertension,diabetes,and SS in the normal group were lower than those in the decreased group(P<0.05).Multivariate analysis showed that age≥60 years,hypertension,diabetes,systolic blood pressure≥140 mmHg and SS were independent risk factors for predicting cognitive decline(P<0.05).Conclusion SS is related to the decline of cognitive function,and the cognitive function decreases with the severity of stenosis.