高血压病患者血管性轻度认知功能障碍的认知损害特点及危险因素分析

Analysis of the Cognitive Impairment Characteristics and Risk Factors in Hypertensive Patients with Vascular Mild Cognitive Impairment

目的:探讨高血压病患者血管性轻度认知功能障碍的认知损害特点及危险因素。方法:随机选取2013年1月-2016年10月笔者所在医院门诊和住院收治的高血压病患者164例,其中合并脑梗死者44例,分为存在血管性轻度认知功能障碍的Va MCI组和认知功能正常组的N组,分析Va MCI组患者的认知损害特点,并分析两组患者在年龄、性别、受教育年限、高血压病年限、平均收缩压水平、是否合并脑梗死等因素方面有无差异。结果:69例非痴呆的高血压病患者存在轻度认知功能障碍,发病率42.1%,其中高血压合并脑梗死44例患者中检出存在Va MCI 22例(50%);Va MCI组的注意力、延迟回忆、视空间执行力评分均低于N组,比较差异均有统计学意义(P<0.05);经多因素Logistic回归分析后发现:低教育水平、收缩压控制差及合并急性脑梗死是高血压病患者发生Va MCI的独立危险因素(P<0.05)。结论:非痴呆的高血压病患者部分存在血管性轻度认知功能障碍,主要表现为注意力、延迟回忆、视空间执行力的认知受损;低教育水平、收缩压控制差、合并急性脑梗死是高血压病患者发生Va MCI的独立危险因素。

Objective：To explore the cognitive impairment characteristics and risk factors of hypertensive patients with vascular mild cogintive impairment.Method：From January 2013 to October 2016,164 patients with hypertension admitted to the outpatient and inpatient in author＇s hospital,including 44 patients with cerebral infarction,which were divided into Va MCI group with mild vascular cognitive impairment and N group with normal cognitive function.The characteristics of cognitive impairment in patients with Va MCI were analyzed,and whether there were differences in age,gender,years of education,duration of hypertension,average SBP,and whether or not cerebral infarction were combined.Result：69 patients with non-dementia hypertension had mild cognitive impairment.The incidence rate was 42.1%,22 patients had Va MCI（50%） of the 44 patients with hypertensive cerebral infarction.The scores of attention,delayed recall and visual spatial execution in group Va MCI were all lower than those in group N,and the difference was statistically significant（P〈0.05）.After multivariate logistic regression analysis,it was found that low education levels,poor systolic blood pressure control,and acute cerebral infarction were independent risk factors for Va MCI in hypertensive patients（P〈0.05）.Conclusion：The non-dementia hypertensive patients partly have mild vascular cognitive impairment,which are mainly manifested in cognitive impairment of attention, delayed recall and visual spatial execution;low education level,poor systolic blood pressure control and acute cerebral infarction are independent risk factors for Va MCI in patients with essential hypertension.