中老年原发性高血压患者智能变化分析

Intellectual changes in middle-aged and elderly patients with essential hypertension

目的:探讨中老年原发性高血压患者智能的变化及不同高血压水平、是否合并加重预后危险因素的高血压患者智能的差异。方法:采用中国韦氏智力测试量表对2004-01/12解放军总医院老年科住院治疗的原发性高血压患者(年龄≥50岁)94例进行评估,并与年龄和性别相似的健康体检者80例比较。观察中老年原发性高血压患者与对照组智能水平的差异,以及不同高血压水平、有无合并加重预后的危险因素的高血压患者的智能差异。结果:按意向处理分析,高血压组94例,对照组80例纳入结果分析。①高血压组患者在填图(11.64±4.51)和图形排列(17.14±6.83)两项测验得分低于对照组(分别为16.14±4.33和24.15±9.63),差异有显著性(t=2.176,2.059;P均<0.05)。②按高血压水平分级比较,中重度高血压患者的算术(8.64±3.01)、数字广度(36.78±17.56)、填图(10.20±4.32)和图形排列(13.69±5.64)测验得分明显低于轻度高血压患者,差异有显著性(t=2.146,2.039,2.094,2.249;P<0.05)。③按有无危险因素分组比较,合并加重预后的危险因素的老年高血压患者领悟(17.46±6.58)、算术(7.69±3.54)、数字广度(35.11±15.89)、数字符号(36.44±15.60)、填图(8.96±3.05)和图形排列(12.54±3.30)测验低于未合并加重预后的危险因素患者。

AIM: To investigate the intellectual changes of middle aged and elderly patie nts with essential hypertension(EH),and study the intellectual differences among hypertensive patients with different hypertensive level and those with or witho ut the risk factors that could aggravate their prognosis. METHODS: Ninety four EH patients aged no younger than 50 years old,who were h ospitalized in the Department of Geriatrics,General Hospital of Chinese PLA from January to December 2004,were assessed with Wechsler adult intelligence scale revised China(WAIS RC),and the results were compared with thoses of 80 healthy physical examinees of the same age and gender.The difference of intellectual lev el between EH patients and the controls were observed,and the intellectual diffe rence was also observed among hypertensive patients with different hypertensive level and those with or without the risk factors that could aggravate their prog nosis. RESULTS: According to intention to treat(ITT) analysis,94 cases in the hyper tension group and 80 cases in the control group were involved in the analysis of results.①The scores of picture completion and picture arrangement were signifi cantly lower in the hypertension group(11.64±4.51,17.14±6.83) than in the cont rol group(16.14±4.33,24.15±9.63)(t=2.176,2.059;P < 0.05).②In comparison accor ding to the classification of hypertensive level,the scores of arithmetics,digit span,picture completion and picture arrangement in the moderate to severe hyper tension group(8.64±3.01,36.78±17.56,10.20±4.32,13.69±5.64) were significantl y lower than those in the mild hypertension group(t=2.146,2.039,2.094,2.249;P< 0 .05).③In comparison between groups of with or without risk factors,elderly hype rtensive patients with risk factors that could aggravate their prognosis had sig nificantly lower scores of insight (17.46±6.58),arithmetics(7.69±3.54),digit s pan (35.11±15.89),digital sign(36.44±15.60),picture completion(8.96±3.05) and picture arrangement(12.54±3.30) than those without the risk factors(t=2.134 to 2.235,P< 0.05). CONCLUSION: Intellectual impairment in middle aged and elderly hypertensive p atients is unobvious as compared with that in normal subjects.The intellectual l evel is lower in middle aged and elderly hypertensive patients with higher bloo d pressure level and complicated by more risk factors than in those with lower b lood pressure level and complicated with fewer risk factors.