摘要
目的观察老年患者血压水平及相关危险因素对认知功能的影响。方法选择2008年8月至2009年2月仁济医院老年病科门诊及潍坊社区卫生服务中心全科门诊就诊的年龄≥60岁的老年患者,排除有恶性肿瘤、血液系统疾病、恶病质等疾病,或因自身原因不能配合完成量表检查患者。入选高血压组124例,正常血压组51例。以蒙特利尔认知评估(MoCA)为工具检查所有研究对象的认知功能状况,记录其血压及生化等相关指标。结果高血压组MoCA总得分、视空间与执行功能、注意、语言、延迟回忆得分明显降低(P<0.05)。高血压组患者中MoCA评分正常组24h平均舒张压及白天平均舒张压较评分减低组明显升高,血压昼夜节律存在者比例明显增多,差异有统计学意义(P<0.01)。昼夜节律、白天平均舒张压与MoCA评分呈正相关,年龄与MoCA评分呈负相关。结论 MoCA对认知功能减退患者敏感性较高,可作为临床早期筛查认知能减退的首选量表。年龄、昼夜节律、白天平均舒张压是预测高血压患者MoCA评分的独立变量。
Objective To investigate the relationship between cognitive function and blood pressure in the elderly,as well as the influence of related risk factors.Methods A total of 175 patients over 60 years old were categorized in 2 groups:124 hypertensives and 51 normotensives.The Montreal Cognitive Assessment(MoCA)was used to determine cognitive change.The parameters of blood pressure and biochemical indicators were observed.SPSS 13.0 was used to perform the statistic analysis.Results The MoCA scores of total score,subscores of visuospatial and executive,attention,language,delayed recall were significantly decreased in hypertensive group(P<0.05).24 h mean diastolic blood pressure(MDBP),daily mean diastolic blood pressure(dMDBP) and the proportion of normal circadian rhythm were significantly increased in hypertensive patients whose MoCA scores were normal(P<0.01).Age was negative linear correlation with the MoCA scores.Circadian rhythm and dMDBP were positive linear correlation with the MoCA scores.Conclusions MoCA is sensitive in clinical assessment of cognitive impairment.The data suggest that age,circadian rhythm and dMDBP appeared to be independent variables for predicting the MoCA scores in patients with hypertension.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第17期4949-4952,共4页
Chinese Journal of Clinicians(Electronic Edition)
