老年冠心病与轻度认知障碍相关性研究

Association of mild cognitive impairment with coronary artery disease in elderly patients

目的 探讨老年冠心病及其他血管危险因素与轻度认知障碍之间的关系。方法 选取2015年4－9月在心血管内科住院的老年患者196例，制订统一的认知损害现状调查表，应用蒙特利尔认知评估量表将患者分为轻度认知障碍133例，认知正常63例，所调查患者均行冠状动脉造影术检查，依据冠状动脉狭窄程度分为冠心病79例，冠状动脉造影阴性117例。分析冠心病及其他血管危险因素与轻度认知障碍的相关性。 结果 轻度认知障碍患者与认知正常患者受教育年限分别为（9.23 ± 4.34）、（12.27 ± 3.79）年，两者比较差异有统计学意义（t=4.77，P〈0.05）；冠心病所占比例分别为45.9%（61/133）、28.6%（18/63），两者比较差异有统计学意义（χ2=5.31，P〈0.05）；经Logistic回归分析，得出受教育年限[优势比（OR）0.86，95%可信区间（CI）0.77~0.91；P=0.00]为轻度认知损害的保护性因素，冠心病（OR值2.02，95%CI 1.03~4.00；P=0.04）为轻度认知损害的独立危险因素，且冠心病患者与冠状动脉造影阴性患者蒙特利尔认知评估量表总得分分别为（20.9 ± 4.8）、（22.4 ± 5.6）分，在认知损害领域延迟记忆方面得分分别为（2.1 ± 1.6）、（2.6 ± 1.8）分，两者比较差异有统计学意义（t=1.98、2.19，均P〈0.05）。结论 受教育年限为老年人轻度认知损害的保护性因素，冠心病为老年人轻度认知损害的独立危险因素，且以延迟记忆受损为主。

Objective To investigate the relationship between coronary artery disease, other vascular risk factors and mild cognitive impairment in elderly patients. Methods A total of 196 inpatients were collected from the departments of cardiovascular internal medicine from April to September 2015.The unified questionnaires of cognitive status and standardized survey were developed. The patients were divided into 133 cases of mild cognitive impairment and 63 cases of cognitively normal by Montreal Cognitive Assessment Scale. The patients were divided into 79 cases of coronary heart disease and 117 cases of negative control by coronary angiography. Coronary artery disease and other vascular risk factors for mild cognitive impairment were analyzed.Results The levels of education and proportion of coronary heart disease were （9.23±4.34） years and 45.9%（61/133） in mild cognitive impairment patients, and （12.27±3.79） years and 28.6% （18/63） in cognitively normal patients. There were significant differences between the two（t = 4.77, P〈 0.05, χ2=5.31, P〈 0.05）. Multivariate Logistic regression analysis showed that degree of education was a protective factor for mild cognitive impairment with odds ratio （OR） 0.86, 95% confidence interval （CI） 0.77 to 0.91 and P = 0.00. Coronary heart disease was an independent risk factor for mild cognitive impairment （OR=2.02, 95%CI 1.03 to 4.00; P = 0.04） . The total scores of Montreal Cognitive Assessment Scale and delayed memory were （20.9±4.8）, （22.4±5.6） points and （2.1±1.6）, （2.6±1.8） points in coronary heart disease and negative control patients. There were significant differences between the two （t=1.98, 4.77, all P〈0.05）. Conclusions The degree of education is a protective factor for mild cognitive impairment. Coronary heart disease is an independent risk factor for mild cognitive impairment, and it mainly impairs delayed memory ability.