老年代谢综合征患者认知功能与血压昼夜节律的关系

Relationship between cognition function and circadian rhythm of blood pressure in elderly patients with metabolic syndrome

目的探讨老年代谢综合征(MS)患者认知功能与血压昼夜节律的关系。方法选择223例老年MS患者作为MS组,行24 h动态血压监测,根据夜间血压下降率,再将患者分为杓型组(血压下降率10%～20%,64例)、非杓型组(血压下降率<10%,53例)、超杓型组(血压下降率>20%,55例)和反杓型组(血压升高,51例)4个亚组;另选同期健康体检者100例为对照组。用简易智能状态检查量表(MMSE)对受试者进行认知功能调查,并进行比较。结果 MS组MMSE评分明显低于对照组(P<0.05)。非杓型组、超杓型组和反杓型组MMSE评分明显低于杓型组,超杓型组和反杓型组MMSE评分明显低于非杓型组(P<0.05),超杓型组与反杓型组MMSE评分差异无统计学意义(P>0.05)。结论老年MS患者认知功能下降,可能与血压昼夜节律减弱或消失有关。

Objective To explore the relationship between blood pressure circadian rhythm and cognition function in the elderly patients with metabolic syndrome（MS）. Methods 223 elderly MS patients received 24 hour ambulatory blood pressure monitoring,and were divided into dipper group （n = 64）,non dipper group （n =53）,super-dipper group （n = 55） and reverse-dipper group （n = 51）. 100 healthy subjects served as controls. Cognition funtion was evaluated by MMSE. Results MMSE score of MS group was significantly lower than that of control （P〈0.05）. MMSE scores of non-dipper group,super-dipper group and reverse-dipper group were significantly lower than that of dipper group. MMSE scores of super-dipper group and reverse-dipper group were also lower than that of non-dipper group （P 〈 0. 05）,but there was no significant difference between super dipper group and reverse dipper group. Conclusion The decrease in cognition function in the elderly patients with metabolic syndrome may be ralated with the attenua- tion or disappearance of 24-hour ambulatory blood pressure circadian rhythm.