心力衰竭患者认知障碍的研究进展

Research progress in cognitive impairment in patients with heart failure

认知障碍在心力衰竭患者中较常见,认知损害涉及不同的认知领域,包括记忆、注意、执行功能、精神运动速度、语言和视空间等,进而影响患者的自我护理能力、治疗方案的配合程度以及症状恶化时的决策能力。因此对心力衰竭患者认知障碍的早期识别和及时干预具有重要的临床意义,但目前对心力衰竭患者的认知障碍认识不足,在筛查工具、治疗措施等方面缺乏共识。心力衰竭相关认知障碍的发生机制是多因素综合的结果,主要与循环功能不全与大脑相关改变有关。心力衰竭主要影响记忆、注意力、执行功能等认知领域,简易智力状态评估量表(MINI-COG)为评估的首选量表。使用MRI,f MRI,经颅多普勒等器械检查,采用手术、教育、药物、理疗、有氧运动等治疗方法,通常采用综合干预措施。

Cognitive impairment is common in heart failure patients which involve different cognitive domains, including memory, attention, executive function, language and psychomotor speed, language and visual space. It affects the patient＇s self-care ability, the degree of coordination of the treatment plan, and the decision-making ability when the symptoms deteriorate. Therefore, the early recognition and timely intervention of cognitive impairment in patients with heart failure is very necessary and has important clinical significance. However, there is a lack of understanding of cognitive impairment in patients with heart failure, and lack of consensus in screening tools and treatment measures. The mechanism of cognitive impairment related to heart failure is the result of multifactor synthesis, which is mainly related to circulatory dysfunction and changes in the brain, mainly affecting the cognitive fields such as memory, attention, executive function, etc. MINI-COG is the first choice of the assessment scales. The instruments used are MRI, f MRI, and transcranial Doppler. The therapeutic measures include surgery, education, medicine, physical therapy, aerobic exercise, etc. Generally, comprehensive intervention measures are used.