原发性高血压合并抑郁症患者的认知功能研究

Cognitive function in patients of primary hypertension with depression

目的了解原发性高血压合并抑郁症对患者认知功能的影响。方法选取2013年2月-2015年1月该院收治的47例原发性高血压合并抑郁症患者及50例单纯高血压患者为研究对象,并选择40例健康成人作为对照组,以蒙特利尔认知评估量表(Mo CA)评估3组的认知功能,采用多因素Logistic回归探讨认知功能减退的影响因素。结果原发性高血压合并抑郁症组的视空间与执行功能、语言、抽象等方面的评分及总分均显著低于对照组(P<0.05),而单纯原发性高血压组的Mo CA总分显著低于对照组(P<0.05)。多因素Logistic回归分析结果表明,年龄、脉压差(PP)、汉密尔顿抑郁量表(HAMD)评分是认知功能损害的独立危险因素(P<0.05)。结论与单纯性原发性高血压和健康成人相比,原发性高血压合并抑郁症患者的认知功能明显减退,高龄、高PP、高HAMD评分可显著增加机体发生认知功能减退的风险。

[Objective] To study the effect of primary hypertension with depression on cognitive function of patients. [Methods ] In this study, 47 patients with both primary hypertension and depression, 50 patients with primary hypertension from Feb. 2013 to Jan. 2015 and 40 normal controls were enrolled. Montreal Cog- nitive Assessment Scale （MoCA） was performed to evaluate their cognitive function. Multivariate logistic regres- sion analysis was used to investigate the related factors of damage of cognitive function. [Results] The scores of visual space, executive function, language and abstract, and the total score of MoCA in the primary hyper- tension with depression group were significantly lower than those in the control group （P 〈 0.05）. The total MoCA score in the primary hypertension group was significantly lower than that in the control group （P 〈 0.05）. The result of multivariate logistic regression analysis showed that age, pulse pressure （PP） and the score of Hamilton＇s Depression Scale （HAMD） were independent risk factors of cognitive impairment （P 〈 0.05）. [Conclusions] Compared with people with simple primary hypertension and healthy adults, the cognitive func- tion in patients with primary hypertension and depression obviously decreases. And older age, high PP and high HAMD score could significantly increase the risk of cognitive decline.