慢性阻塞性肺疾病患者轻度认知功能障碍的相关因素研究

Related factors of mild cognitive impairment in patients with COPD

目的探究影响慢性阻塞性肺疾病(COPD)患者轻度认知功能障碍的相关因素。方法选取确诊COPD患者59例,按蒙特利尔认知评估量表(MOCA)评分分为观察组和对照组,观察组为有轻度认知功能障碍的COPD患者39例,对照组为无认知功能障碍的COPD患者20例。比较两组患者的年龄、MOCA评分、受教育年限、吸烟指数、冠心病、高血压、抑郁程度,并采用logistic分析轻度认知功能障碍与各参数相关性。结果观察组患者平均年龄大于对照组,MOCA评分和受教育年限低于对照组,差异均有统计学意义(t分别=2.27、2.25、2.44,P均<0.05),观察组患者合并有冠心病、高血压的比例高于对照组,抑郁自评量表(SDS)评分>50分比例也高于对照组(χ2分别=5.02、4.88、3.92,P均<0.05)。logistic分析法显示,年龄、吸烟、冠心病、高血压、SDS和COPD严重程度是轻度认知功能障碍的高危因素(OR分别=1.44、3.52、1.99、3.01、1.99、3.52,P均<0.05)。结论吸烟、高龄、COPD严重程度、高血压、冠心病和抑郁均是COPD患者轻度认知功能障碍的高危因素,应尽早进行诊治。

Objective To explore the related factors of mild cognitive impairment in patients with chronic obstructive pulmonary disease（COPD）. Methods Totally 59 patients with COPD were divided into observation group and control group according to the Montreal cognitive assessment scale（MOCA）score. A total of 39 patients with mild cognitive impairment were enrolled in the observation group and 20 patients without cognitive impairment in the control group. The age,MOCA score,years of education,smoking index,coronary heart disease,hypertension and depression were compared between the two groups,and the correlation between mild cognitive impairment and various parameters was analyzed by logistic analysis. Results The patients in the observation group were older than patients in the control group,and the MOCA score and the length of education were lower than those of the control group. The difference was statistically significant（t= 2.27,2.25,2.44,P〈0.05）. The proportions of patients with coronary heart disease and hypertension of the observation group were significantly higher than those of the control group as well as the proportion of patients with SDS score higher than 50（χ2= 5.02,4.88,3.92,P〈0.05）. Logistic analysis showed that age,smoking,coronary heart disease,hypertension,SDS and COPD severity were risk factors for mild cognitive impairment（OR=1.44,3.52,1.99,3.01,1.99,3.52,P〈0.05）. Conclusion Smoking,elderly,severity of COPD,hypertension,coronary heart disease and depression are the high risk factors for mild cognitive impairment.