老年高血压患者颈动脉硬化与血尿酸及认知功能障碍的关系

Correlation among carotid atherosclerosis,serum uric acid,and cognitive dysfunction in senile patients with hypertension

目的探讨老年高血压病患者颈动脉粥样硬化与血尿酸水平及认知功能障碍之间的关系。方法按颈总动脉的内膜中层厚度(IMT),将64例老年高血压病患者分为内膜正常组、内膜增厚组和斑块形成组,测定各组患者血尿酸水平,并使用中文版简易智能状态检查表(MMSE)对受试者进行认知功能调查。结果内膜正常组、内膜增厚组、斑块形成组血尿酸水平分别为(251±43)、(316±45)、(364±53)μmol/L,3组间比较差异有统计学意义(P<0.05),颈总动脉IMT与血尿酸水平呈正相关(P<0.05),随着IMT的增厚,血尿酸水平依次增高;内膜增厚组和斑块形成组在定向力、记忆力、注意力和计算力、回忆力以及语言力等方面评分均低于内膜正常组(P<0.05)。结论老年高血压病患者高尿酸血症是颈动脉粥样硬化的一项危险因素,伴有颈动脉粥样硬化的老年高血压病患者更易出现认知功能损害。

Objective To explore the correlation among carotid atherosclerosis,serum uric acid,and cognitive dysfunction in senile patients with hypertension.Methods According to the intima-media thickness（IMT） of carotid artery,64 senile patients with hypertension were divided into the normal intima group,thickening intima group,and formed plaque group.The levels of serum uric acid in each group were measured.Mini Mental State Examination（MMSE） was carried out to investigate the cognitive function of those subjects.Results The levels of uric acid in the three groups were（251 ± 43） μmol / L,（316 ± 45） μmol / L,and（364 ± 53） μmol / L,respectively.There were significant differences among the three groups（P ＆lt; 0.05）.There was an independent and negative correlation between the carotid artery IMT and the level of serum uric acid（P ＆lt; 0.05）.Along with the thickening of IMT,the level of serum uric acid increased by turns.The scores of orientation,memory,attention,calculation capability,recollection ability,and linguistic capability in the thickening intima group and formed plaque group were all lower than those in the normal intima group（P ＆lt; 0.05）.Conclusion Hyperuricemia is one risk factor of carotid artherosclerosis in senile patients with hypertension.Those with hypertension complicated with carotid atherosclerosis easily suffer from cognitive function lesion.