老年高血压病引起的记忆功能障碍、中医症候及相关危险因素研究

Related Research on Risk Factors in Elderly Patients with Hypertension Cognitive Impairment

目的研究老年高血压患者记忆功能障碍、中医症候及相关危险因素。方法将152例高血压患者分为两组,选取出现记忆障碍的患者设为治疗组,选取未出现记忆障碍的高血压患者作为对照组。两组进行精神状态检查和行为记忆测验。结果治疗组收缩压、舒张压、脉压显著高于对照组(P<0.05);经过简易精神状态检查表(MMSE)量表测量后发现,治疗组患者在定向力、短时记忆和总评分水平上低于对照组(P<0.05);高血压III级患者的MMSE评分、行为记忆测验法评分(RBMT-II)均高于高血压I级和II级患者(P<0.05)。高血压II级患者RBMT-II记忆标准评分高于高血压I级患者(P<0.05);治疗组患者收缩压、脉压与RBMT-II记忆标准评分呈现显著负相关,治疗组患者收缩压与MMSE评分呈现负相关关系;采用Logistic回归分析方法分析显示年龄增大、肥胖、收缩压和脉压增大是高血压患者认知障碍的独立危险因素(P<0.05)。结论患者血压水平越高,记忆功能受损就越严重,年龄增大、肥胖、收缩压和脉压增大是高血压患者认知障碍的危险因素。

Objective To study the related research on risk factors in elderly patients with hypertension cognitive impairment. Methods152 cases of high blood pressure patients with cognitive impairment were selected as observation group,high blood pressure patients without congnitive impairment were selected as control group. Mini mental state examination（ MMSE） and behavioral memory testing（ RBMT-Ⅱ） were carried out in both groups. Results Systolic blood pressure（ t = 21. 28,P〈0. 001）,diastolic blood pressure（ t = 6. 978,P〈0. 001）,pulse pressure（ t = 10. 79,P〈0. 001） of treatment group were significantly higher than those of control group,the difference was statistically significant（ P〈0. 05）; MMSE scale measurements were showed that the directional feel（ t = 2. 521,P = 0. 013）,short- term memory（ t = 3. 225,P= 0. 002） and total score level（ t = 8. 644,P〈0. 001） in observation group were lower than those of control group,the difference was statistically significant（ P〈0. 05）; MMSE score,RBMT- II memory score of patients with high blood pressure level III were higher than patients with high blood pressure level I and level II,the difference were statistically significant（ P〈0. 05）. RBMT- II memory scale scores of hypertension patients of high pressure level Ⅲ were higher than those of patients with high blood pressure level I,II with statistically significant difference（ P〈0. 05）; systolic blood pressure,pulse pressure and RBMT- II memory scale scores of observation group showed significant negative correlation（ r =- 0. 403,P〈0. 001 vs r =- 0. 348,P = 0. 001）,systolic blood pressure and MMSE score of observation group showed negative correlation（ r =- 0. 224,P = 0. 224）. By using the way of Logistic regression analysis,it showed that the increase of age,obesity,systolic blood pressure and pulse pressure is independent risk factor for hypertension patients with cognitive impairment,the differences were statistically significant（ P〈0. 05）. Conclusions The higher pressure level,the more damage for memory. The increase of age,obesity,systolic blood pressure and pulse pressure are the risk factors for cognitive impairment in patients with high blood pressure.