慢性阻塞性肺疾病患者轻度认知功能障碍的相关影响因素

Related factors of mild cognitive dysfunction of the patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者轻度认知功能障碍的影响因素。方法对2014年1月至2016年1月来东莞市东城医院救治的92例COPD患者的临床资料进行回归性分析,依据蒙特利尔认知评估量表来了解所选患者的认知功能,将所选患者分为轻度认知功能障碍组与认知功能正常组,然后用统计学的单因素和多因素分析对COPD患者发生轻度认知功能的相关因素进行分析。结果所选的92例COPD患者中有66例患者发生了轻度认知功能障碍,其发生率为71.74%(66/92)。轻度认知功能障碍组66例,男性42例,女性24例,平均年龄(76.2±1.4)岁,平均病程(48.2±1.4)个月;认知功能正常组26例,男性16例,女性10例,平均年龄(56.1±1.2)岁,平均病程(41.2±1.3)个月。单因素分析结果显示年龄、吸烟、文化程度、运动、睡眠、炎症、血氧分压(Pa O2)、二氧化碳分压(Pa CO2)及病程与COPD患者发生轻度认知功能障碍有关。多因素回归分析显示年龄、文化程度、Pa O2及Pa CO2的水平是COPD患者发生认知功能障碍的独立危险因素。结论 COPD患者发生轻度认知障碍的概率很高,患者的年龄、文化程度、Pa O2及Pa CO2的水平均是COPD患者发生轻度认知障碍的独立危险因素,对存在危险因素的COPD患者应采取早期预防及积极治疗。

Objective To explore the related factors of mild cognitive dysfunction in patients with chronic ob-structive pulmonary disease（COPD）. Methods The clinical data of 92 patients with COPD in our hospital from January2014 to January 2016 was collected for regression analysis. The patients were divided into mild cognitive dysfunction groupand normal cognitive function group, according to the cognitive function assessed by Montreal Cognitive Assessment（Mo-CA）. The related factors of mild cognitive dysfunction in patients with COPD were analyzed by single factor and multiplefactors analysis. Results There were 66 patients who had mild cognitive dysfunction in the 92 patients, including 42 males and 24 females, with mean age of（76.2±1.4） years and mean disease course of（48.2±1.4） months, and the incidencewas 71.74%（66/92）. Normal cognitive function group（26 patients） included 16 males and 10 females, with mean age of（56.1±1.2） years and mean disease course of（41.2±1.3） months. Single factor analysis showed that age, smoking, education-al level, movement, sleep, inflammation, blood oxygen partial pressure（Pa O2）, CO2 partial pressure（Pa CO2） and diseasecourse were associated with mild cognitive dysfunction in patients with COPD. Multiple factors regression analysis showedthat age, educational level, Pa O2 and Pa CO2 were the independent risk factors for the development of cognitive dysfunctionin patients with COPD. Conclusion The chance of mild cognitive impairment in the patients with COPD is very high.The age, educational level, Pa O2 and Pa CO2 are all independent risk factors for the development of cognitive dysfunction inpatients with COPD. The COPD patients with risk factors should be given early prevention and active treatment.