高龄男性冠状动脉钙化与痴呆、冠状动脉粥样硬化性心脏病的相关性

Relationship of Coronary Artery Calcification with Dementia and Coronary Heart Disease in Very Elderly Men

目的分析高龄男性冠状动脉钙化(CAC)与痴呆和冠状动脉粥样硬化性心脏病(CHD)患病率、死亡率的关系。方法收集我院2004年老年科75~85岁男性患者病历资料,存在CAC但未诊断痴呆和CHD的男性患者(386例)作为研究对象,回顾至2016年(12年)或至死亡。根据CAC程度(≤10、>10~100、>100~400、>400)分组,记录颈动脉超声、头MRI、神经心理学测试和心血管疾病危险因素检测结果。分析CAC与痴呆、CHD患病率及死亡率的关系;分析痴呆同累计生存率的关系。结果 CAC同年龄和颈动脉狭窄相关(均P<0.001);CAC同死亡率、痴呆及CHD患病率显著相关(χ2分别为25.951、1 176.0、1 122.0,均P<0.001)。痴呆患者的累计生存率显著低于其他患者(χ~2=50.365,P<0.001;HR=2.49,95%CI:1.89~3.27,P<0.001)。结论CAC增加了患者痴呆和CHD患病及死亡的风险。与CHD患病率比较,高龄男性患者的痴呆患病率高;痴呆显著增加了患者死亡的风险。

Objective To evaluate the relationship of coronary artery calcification(CAC)with the risk of death,dementia,and coronary heart disease(CHD)in elderly men.Methods Data of male patients aged 75-85 years were collected from 2004.In total,386 men had CAC without dementia and CHD.They were grouped according to the degree of CAC(≤10,>10 to 100,>100 to 400,>400),and data were reviewed until 2016 or until their death.The results of carotid ultrasound,magnetic resonance imaging of the brain,neuropsychological tests,and risk factors for CHD were recorded.The relationships between CAC scores and the risk of mortality,dementia,and CHD and between dementia and cumulative survival rate were analyzed.Results CAC was associated with age,carotid stenosis,mortality,dementia,and the prevalence of CHD(all P<0.001).The cumulative survival rate of patients with dementia was significantly lower than that of the other patients(χ2=50.365,P<0.001;HR=2.49,95%CI:1.89-3.27,P<0.001).Conclusion CAC increases the risk of dementia,CHD,and mortality.In older men,the prevalence of dementia is higher than that of CHD,and dementia significantly increases the risk of death.