慢性阻塞性肺疾病患者认知障碍发生与BODE指数的相关性研究

The Correlation Study between Cognitive Impairment in Patients with Chronic Obstructive Pulmonary Disease and BODE Index

目的分析BODE指数与认知障碍发生的相关性,为临床早期干预提供依据。方法纳入2014年1月至2015年6月在我院就诊的51例慢性阻塞性肺疾病为研究组,同期纳入年龄、性别相匹配的健康体检者51例作为对照组。此外,将研究组患者以中文版蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)评分≤26分将患者分为认知障碍组及非认知障碍组。收集所有患者临床资料,包括疾病史、吸烟史、合并疾病、住院次数、病程、受教育年限、经济收入等,测定患者BODE指数。结果研究组共19例患者MoCA评分≤26分,认知障碍发生率为38.3%;对照组共4例患者MMSE评分≤26分,认知障碍发生率为7.8%。两组认知障碍发生率差异有统计学意义(P<0.05)。将BODE分级与MoCA评分进行相关性分析,结果显示BODE分级与MoCA评分呈显著负相关(r=-0.63,P<0.05)。以发生认知障碍为因变量,以吸烟指数、病程、经济收入、住院次数、受教育年限、BODE指数为自变量进行Logistic回归分析,结果发现病程、住院次数、受教育年限、BODE分级为COPD患者发生认知障碍危险因素。结论 BODE指数为一种简单易测的常规指标,可以对患者的认知障碍发生起到提示作用。

Objective To analyze the correlation between BODE index and cognitive impairment,and to provide evidence for early clinical intervention. Methods 51 patients with chronic obstructive pulmonary disease in our hospital between January 2014 and June 2015 were included in the study group,and 51 healthy persons matched by age and gender were included in the study group. In addition,in the study group,according to if patient in the Chinese version of the montreal cognitive assessment （MoCA） score was less than or equal to 26,patients were divided into cognitive impairment group and non cognitive impairment group. The clinical data of all patients were collected,including disease history,smoking history,combined diseases,hospitalization times,course of disease,duration of education,economic income and so on. The BODE index of patients was measured. Results In study group,19 cases of MoCA score were less than or equal to 26 points and the occurrence rate of cognitive impairment was 38. 3%;in control group 4 cases of patients with MMSE score were less than or equal to 26 points and the occurrence rate of cognitive impairment was7. 8%. There was significant difference in the incidence of cognitive impairment between the two groups（P〈0. 05）. Correlation analysis between BODE classification and MoCA score showed significant negative correlation between BODE score and MoCA score（r=-0. 63,P〈0. 05）. The occurrence of cognitive impairment was set as the dependent variable and the smoking index,course of disease,economic income,times of hospitalization,years of education,the BODE index were set as independent variables in logistic regression analysis. The results showed that the duration,times of hospitalization,years of education,and BODE grading were risk factors for patients with COPD. Conclusion BODE index is a simple and easy measurement of the conventional indicators,and it can play a role in the occurrence of patient’s cognitive impairment.