慢性心力衰竭对老年人认知功能纵向变化速度的影响

Effect of chronic heart failure on longitudinal cognitive function in elderly subjects

目的观察慢性心力衰竭(CHF)对老年人认知功能纵向变化速度的影响并探讨其机制。方法采用前瞻性病例对照研究,排除死亡患者后,最终选择88例CHF患者为CHF组及93例体检的老年人为对照组。对2组基线认知功能与全身临床状况进行评估。连续随访2年,评估简易智能状态检查量表(MMSE)、词语学习及延迟回忆、动物流畅性及符号数字转换测验。采用随机效应模型分析CHF对基线认知功能及认知功能变化速度的影响。结果与对照组比较,CHF组高血压比例明显升高(P<0.01),词语学习、动物流畅性、符号数字转换明显降低(P<0.05,P<0.01)。调整高血压影响后,CHF组MMSE、词语学习及延迟回忆、动物流畅性及符号数字转换测验的下降速度较对照组明显加快(P<0.01)。结论 CHF患者的认知功能下降速度较对照人群明显加快。

Objective To study the effect of CHF on longitudinal cognitive function in elderly sub- jects and its mechanism. Methods Eighty-eight CHF patients served as a CHF group and 93 healthy elderly subjects served as a control group in this prospective control study. Their baseline cognitive function and general clinical condition were assessed according to the MMSE, word learning and delayed recall, animal fluency, symbol and digit transformation tests. The patients were followed up for 2 years,during which their cognitive function was assessed. Effect of CHF on baseline cognitive function and its changing speed was analyzed according to the random effect model. Results The incidence of hypertension was significantly higher whereas the percentages of word learning and delayed recall, animal fluency, symbol and digit transformation were significant- ly lower in CHF group than in control group （P〈0.05 ,P〈0.01）. The MMSE,word learning and delayed recall,animal fluency, symbol and digit transformation scores were significantly higher in CHF group than in control group （P〈0.01） after adjustment for hypertension. Conclusion The cognitive function impairs faster in CHF patients than in controls.