原发性高血压合并轻度认知功能障碍的相关性研究

Correlation of essential hypertension and mild cognitive impairment in the elderly

目的研究老年人原发性高血压合并轻度认知功能障碍的相关性。方法入选符合标准的老年原发性高血压患者170例，根据动态血压监测结果分为晨峰血压（MBPS）组和非MBPS组。收集受试者的病史，检测血压、体质量指数、空腹血糖、血脂、血清胱抑素C（Cys—C），并用蒙特利尔认知评估（MoCA）量表作为认知功能的测评工具。结果两组患者性别、年龄、体质量指数、空腹血糖、血脂水平差异均无统计学意义（P〉0．05），而血清Cys—C水平、MoCA评分差异有统计学意义（P〈0．05）。多元logistic逐步回归分析结果表明，血清Cys—C水平与MoCA评分结果呈负相关（OR=2．326，P=0．017），由此推测血清Cys-C水平可能是老年人原发性高血压合并轻度认知功能障碍的独立危险因素。结论血清Cys-C水平联合MBPS可更好地评估老年人原发性高血压的轻度认知功能障碍。

Objective To investigate the correlation of essential hypertension and mild cognitive impairment （MCI） in the elderly. Methods A total of 170 elderly patients with confirmed essential hypertension admitted in our department were enrolled in this study. They were divided into morning blood pressure surge （MBPS） group and non-MBPS group according to the results of ambulatory blood pressure monitoring. Clinical data, such as disease history, blood pressure, body mass index （BMI）, fasting blood glucose （FBG）, blood lipids, and serum cystatin-C （Cys-C） were collected. Montreal cognitive assessment （MoCA） scale was used to make cognitive assessment. Results There were no significant differences in the age, gender composition, BMI, FBG and blood lipid levels between the 2 groups （ P 〉 0.05 ）, but obvious differences of MoCA score and serum Cys-C level were seen （ P 〈 0.05 ）. Multivariate regression analysis showed that the Cys-C level was negatively correlated with the MoCA score （OR = 2. 326, P = 0. 017）, which suggested that serum Cys-C level might be an independent risk factor for MCI in the elderly patients with essential hypertension. Conclusion The serum level of Cys-C in combination with MBPS might be better indicators for assessment of MCI in the elderly patients with essential hypertension.