伴低氧血症的慢性阻塞性肺疾病对认知功能障碍的影响

The effect of chronic obstructive pulmonary disease with hypoxemia on cognitive function

目的探讨伴低氧血症慢性阻塞性肺疾病(COPD)对认知功能障碍的影响。方法 208例COPD患者来自大连大学附属新华医院,其中血氧正常COPD患者50例,伴低氧血症COPD患者158例。采用蒙特利尔认知评估量表(MoCA)分析不同缺氧程度COPD患者MoCA总分与各项评分。结果轻度缺氧组、中度缺氧组、重度缺氧组与血氧正常组比较,MoCA总评分降低,差异有统计学意义(P<0.05)。与血氧正常组比较,轻度缺氧组注意力与计算力、延迟记忆、抽象理解评分较低(P<0.05),视空间与执行能力、命名、语言、定向力评分无显著性差异(P>0.05);中度缺氧、重度缺氧组MoCA各项评分均低于血氧正常组(P<0.05)。重度缺氧组MoCA各项评分均低于中度缺氧组(P<0.05)。结论伴低氧血症慢性阻塞性肺疾病对认知功能有一定影响,缺氧程度越重,认知功能障碍越明显。

Objective To investigate the effect of hypoxemia chronic obstructive pulmonary disease （COPD） on cognitive dysfunction. Methods 208 patients with COPD were enrolled in Xinhua Hospital Affiliated to Dalian University,50 patients with normal blood oxygenation （COPD） and 158 patients with hypoxemia COPD.The Montreal cognitive assessment scale （MoCA） was used to analyze the total scores and scores of MoCA in patients with different degrees of hypoxia. Results The total score of MoCA was significantly lower in the mild hypoxia group,moderate hypoxia group,severe hypoxia group and normoxic group （ P 〈0.05）.Compared with the normoxic group,the attention and computational power,delayed memory,and abstract comprehension scores were lower in the mild hypoxia group （ P 〈0.05）,and there was no significant difference in visual space and execution ability,naming,language,and orientation power scores （ P 〉0.05）.The scores of MoCA in the moderate hypoxia and severe hypoxia groups were lower than those in the normal blood oxygenation group （ P 〈0.05）.The scores of MoCA in the severe hypoxia group were lower than those in the moderate hypoxia group （ P 〈0.05）. Conclusion Chronic obstructive pulmonary disease with hypoxemia has a certain influence on cognitive function.The more severe the degree of hypoxia,the more obvious cognitive dysfunction.