老年高血压患者认知功能障碍及其影响因素分析

Cognitive impairment in elderly patients with hypertension and analysis of the related factors

目的探讨老年高血压患者认知功能障碍的影响因素。方法使用简易精神状态量表(mini-mental state examination,MMSE)及蒙特利尔认知评价量表(Montreal cognitive assessment,Mo CA)评估老年高血压患者的认知功能,根据量表得分将老年高血压患者分为认知功能正常组与认知功能障碍组,比较两组之间的血糖水平、血清胰岛素水平、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(methane dicarboxylic aldehyde,MDA)水平。结果老年高血压患者中,与认知功能正常组相比,认知功能障碍组平均年龄较大[(75.48±8.89)岁、vs.(70.74±7.68)岁,P=0.003],差异有显著的统计学意义。两组之间的性别比例,认知功能障碍组与认知功能正常组男性所占比例为(50.00%vs 68.08%,P=0.045),差异有统计学意义。老年高血压患者认知功能的异常主要表现在视空间与执行能力、命名能力、延迟记忆力和定向力4个方面。与认知功能正常组相比,老年高血压患者认知功能障碍组SOD水平较高[(58.76±23.50)vs.(36.09±20.01)U/ml],差异有统计学意义(P=0.004)。IR较高[5.18(2.67-8.59)vs 6.45(4.31-10.83)],差异有统计学意义(P=0.045)。结论高龄、女性老年高血压患者更易发生认知功能障碍,认知损害主要在视空间与执行功能,命名能力、延迟记忆力与定向力方面。老年高血压患者中认知功能障碍组有较高的氧化应激水平和胰岛素抵抗。

Objective To explore the influencing factors of cognitive dysfunction in elderly patients with hypertension. Methods The cognitive function in elderly patients with hypertension was evaluated using the Mini Mental State Scale （MMSE） and Montreal cognitive assessment scale （MoCA） . The elderly hypertensive patients were divided into normal cognitive group and cognitive impairment group according to the scores. The blood glucose levels, serum insulin levels, superoxide dismutase （SOD）, and malondialdehyde Dicarboxylic Aldehyde （MDA） were compared between the two groups. Results Compared with normal cognitive function group in elderly hypertensive patients, the average age of the cognitive impairment group was significantly different from that of the normal cognitive function group[（75.48 ± 8.89） vs （70.74 ± 7.68）, P=0.003]cognitive dysfunction group. The proportion of men between the cognitive function disorder group and normal group was significantly different（50.00% vs 68.08%）, P=0.045]. The main different features of abnormal cognitive function in patients with hypertension in the elderly were naming ability, the visual space and executive ability, delay memory and directional force compared with normal cognitive function. The level of SOD in hypertensive patients with cognitive impairment was significantly higher than that of the patients with normal cognitive function （58.76 ± 23.50） U/ml [vs （36.09 ± 20.01） U/ml] （P = 0.004）.IR of the cognitive impairment group was significantly higher than the normal cognitive function group[5.18 （2.67-8.59） high vs 6.45 （4.31-10.83）], （P=0.045）. Conclusion Femalehypertensive patients are more easily to develop cognitive dysffmction The most prominent cognitive impairments arevisual spatial and executive function, naming ability, delayed memory and directional force. Cognitive dysfunction in elderly patients with essential hypertension have higher levels of oxidative stress and insulin resistance.