65例酒精依赖患者认知功能损害相关影响因素的临床分析

Clinical analysis on the influencing factors of cognitive impairment in 65 alcohol dependent patients

目的探讨酒精依赖患者认知功能损害的特点,并分析相关影响因素。方法采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)对2014年1月1日—12月31日入住四川大学华西医院心理卫生中心的65例酒精依赖患者进行认知功能评价,分析其特点并对相关影响因素进行分析。结果不同饮酒年限组别间Mo CA注意及延迟回忆项目差异具有统计学意义(P<0.05),饮酒年限与Mo CA注意(r=–0.250,P=0.044)及延迟回忆(r=–0.326,P=0.008)项目呈负相关关系;不同年龄组别间Mo CA总分、命名、注意及延迟回忆项目差异具有统计学意义(P<0.05),年龄与Mo CA总分(r=–0.429,P<0.001)、命名(r=–0.261,P=0.035)、注意(r=–0.391,P=0.001)及延迟回忆(r=–0.461,P<0.001)呈负相关;不同文化程度组别间Mo CA总分、视空间与执行功能、语言、抽象、延迟回忆项目差异具有统计学意义(P<0.05),文化程度与Mo CA总分(rs=0.650,P<0.001)、视空间与执行功能(rs=0.540,P<0.001)、语言(rs=0.486,P<0.001)、抽象(rs=0.602,P<0.001)、延迟回忆(rs=0.593,P<0.001)呈正相关;多重线性回归分析中年龄在排除其他变量影响后对Mo CA总分有影响(P<0.01)。结论针对酒精依赖认知功能损害患者,饮酒年限、年龄及文化程度与认知功能有关,年龄较大、饮酒年限较长的酒精依赖患者认知功能损害较严重,临床上应重点关注,及早给予干预。

Objective To explore the characteristics of cognitive impairment in patients with alcohol dependence, and analyze the related influencing factors. Methods The Montreal Cognitive Assessment Scale （MoCA） was used to evaluate the cognitive function of 65 alcohol dependent patients hospitalized between January 1st and December 31st, 2014. The features of cognitive impairment and related influencing factors were analyzed. Results The differences of MoCA attention and delayed recall between different drinking year groups had statistical significance （P〈0.05）. The correlations of drinking year with MoCA attention （r=-0.250, P=0.044）, and with delayed recall （r=-0.326, P-0.008） were both negative. MoCA scores, naming, attention and delayed recall were different statistically among different age groups （P〈0.05）. The correlations of ages with MoCA scores （r=-0.429, P〈0.001）, naming （r=-0.261, P=0.035）, attention （r=-0.391, P=0.001） and delayed recall （r=-0.461, P〈0.001） were all negative. MoCA scores, the visuoconstructional skills, language, abstraction and delayed recall were significantly different among different education level groups （P〈0.05）. The correlations of education level with MoCA scores （rs=0.650, P〈0.001）, the visuoconstructional skills （rs=0.540, P〈0.001）, language （rs=0.486, P〈0.001）, abstraction （r=0.602, P〈0.001） and delayed recall （rs=0.593, P〈0.001） were all positive. Ages had an effect on MoCA scores by multiple linear regression analysis （P〈0.01）. Conclusions For alcohol dependent patients with cognitive impairment, cognitive function is correlated with drinking year, age and education level. The cognitive function is much serious in patients with older age and longer drinking years. This kind of patients should be focused on and intervened early.