老年高血压患者的轻度认知损害：回顾性病例系列研究

Mild cognitive impairment in elderly hypertenive patients： a retrospective case series study

目的探讨高血压和其他血管危险因素与轻度认知损害及其亚型之间的关系。方法收集2011年4月至2011年9月就诊于青岛4家市级医院神经科的门诊及住院患者297例，制定统一的青岛市医院神经科认知损害现状调查表，调查轻度认知损害及其亚型的危险因素。结果单变量分析显示，低受教育年限[优势比（oddsratio，OR）0．239，95％可信区间（confidenceinterval，CI）0．129～0．442；P=0．000]、高血压（OR1．928，95％CI1．107～3．358；P=0．019）和高脂血症（OR1．812，95％CI1．041～3．155；P=0．034）均为轻度认知损害的危险因素；多变量logistic回归分析显示，低教育水平（OR0．807，95％C10．742～0．878；P=0．000）和高血压（OR1．788，95％CI1．004～3．146；P=0．048）为轻度认知损害的独立危险因素，且高血压为非遗忘型轻度认知损害的独立危险因素（OR2．091，95％C11．030～4．242；P：0．041），以视空间和执行能力受损为主（P=0．026）。结论高血压为轻度认矢¨损害及其亚型非遗忘型轻度认知损害的独立危险因素，且以执行能力受损为主。

Objective To investigate the relationship between hypertension, other vascular risk factors and mild cognitive impainment and its subtype. Methods A total of 297 outpatients and inpatients were collected from the Departments of Neurology in 4 municipal hospitals in Qingdao from April 2011 to September 2011. The unified questionnaires of cognitive impairment status in the departments of neurology in Qingdao city were developed. The risk factors for mild cognitive impairment and its subtype were investigated. Results Univariate analysis showed that low levels of education （odds ratio E OR] O. 239, 95% confidence interval I CIJ O. 129 - 0. 442; P = 0. 000）, hypertension （OR 1. 928, 95% CI 1. 107 - 3. 358; P = 0. 019） and hyperlipidemia （OR 1. 812, 95% CI 1. 041~ -3. 155; P =0. 034） were all/he risk factors for mild cognitive impairment; Multivariate logistic regression analysis showed that low levels of education （OR O. 807, 95% CI O. 742 - 0. 878; P =0. 000 and hypertension （OR i. 788, 95% CI 1. 004 -3. 146; P=0. 048 ） were the independent risk factors for mik cogdtive impairment; and hypertension （OR 2. 091, 95% C1 1. 030 - 4. 242; P = 0. 041 ） was an independent risk factor for non-amnestic mild, cognitive impairment, and was mainly impaired visuospatial and executive abilities （P = 0. 026）. Conclusions Hypertension is an independent risk factor for mild cognitive impairment and its subtype-non-arnnestic mild cognitive impairment, and it mainly impairs executive ability.