左心室射血分数与认知损害的关系

Relation between LVEF and cognitive impairment

目的分析LVEF与认知损害的关系,明确慢性心功能不全是否为认知损害的危险因素。方法选择本院进行超声心动图检查的患者250例,超声心动图检测LVEF,患者根据LVEF分为4组：LVEF≤60%组53例、61%~65%组62例、66%~70%组75例、≥71%组60例。应用简易智能状态检查量表（MMSE）评估认知功能,又分为认知损害组50例和认知正常组200例。单因素及多因素分析LVEF与认知损害的关系。结果LVEF≤60%组,61%~65%组,66%~70%组和≥71%组认知损害患病率存在显著差异（45.3%vs 24.2%vs 12.0%vs3.3%,P=0.000）;线性趋势相关检验显示,认知损害患病率与LVEF存在显著线性关系（χ2=33.630,P〈0.01）。MMSE得分与LVEF呈正相关（r=0.372,P〈0.01）。与认知损害相关的因素有高血压（OR=13.649,95%CI：3.379~55.132,P=0.000）;受教育年限（OR=0.855,95%CI：0.786~0.930,P=0.000）以及LVEF（OR=0.929,95%CI：0.899~0.959,P=0.000）。结论 LVEF降低是认知损害的独立危险因素。

Objective To study whether chronic cardiac insufficiency is a risk factor for cognitive impairment by analyzing the relation between LVEF and cognitive impairment.Methods Two hundred and fifty patients who underwent ultrasonic cardiography in our hospital were divided into LVEF ≤60% group（n=53）,LVEF being 61%-65% group（n=62）,LVEF being 66%-70% group（n=75）,and LVEF ≥71% group（n=60）.Their cognitive function was scored according to the MMSE Scale.The patients were further divided into cognitive impairment group（n=50）and non-cognitive impairment group（n=200）.The relation between LVEF and cognitive impairment was analyzed by multivariate logistic regression analysis.Results The incidence of cognitive impairment was significantly higher in LVEF≤60% group than in LVEF being 61%-65% group,LVEF being 66%-70% group and LVEF≥71% group（45.3% vs 24.2% vs12.0%vs 3.3%,χ2=35.273,P0.01）.Multivariate logistic regression analysis showed that cognitive impairment was significantly related with LVEF（χ2=33.630,P0.01）.The MMSE score was positively related with LVEF（r=0.372,P 0.01）.Hypertension,education,and LVEF were the risk factors for cognitive impairment（OR=13.649,95%CI：3.379-55.132,P=0.000;OR=0.855,95%CI：0.786-0.930,P=0.000;OR=0.929,95%CI：0.899-0.959,P=0.000）.Conclusion Low LVEF is an independent risk factor for cognitive impairment.