老年人群认知功能障碍与血压参数的相关性

目的通过对诊室血压、24h动态血压的监测,探讨老年人群认知功能障碍的影响因素.方法通过对纳入本次研究的363例老年人群进行诊室血压、24h动态血压监测及认知筛查,根据MocA得分分为认知正常组(155例)和认知障碍组(208例),比较两组血压变化特征,并进行影响因素分析.结果三次多重线性回归显示,24h动态血压参数中的白天舒张压(OR1=-0.597,OR2=-0.562,OR3=-0.561)、夜间舒张压(OR1=0.777,OR2=0.762,OR3=0.759)、24h平均脉压差(OR1=-0.067,OR2=-0.054,OR3=-0.035)、夜间收缩压下降率异常(OR1=-0.344,OR2=-0.334,OR3=-0.322)、夜间舒张压下降率(OR1=-0.179,OR2=-0.388,OR3=-0.399),均P<0.05,诊室血压各参数未进入回归模型.结论老年人群认知功能障碍与24h动态血压参数有关,与诊室血压参数可能无关.

Objective By monitoring the clinical blood pressure and 24h dynamic blood pressure,the risk factors of cognitive dysfunction in the elderly were investigated.Methods 24h ambulatory blood pressure,clinical blood pressure and cognitive flinction were tested in 363 elderly people.According to Moca score,155 cases were divided into cognitive normal group and 208 cases in group MCI,and the blood pressure characteristics of two groups were compared,and the influencing factors were analyzed.Results Multiple linear regression analysis showed that daytime diastolic pressure(OR1=-0.597,OR2=-0.562,OR3=-0.561),night diastolic pressure(OR1=O.777,OR2=-0.762,OR3=O.759),24h mean pulse pressure(OR1=-0.067,OR2=-0.054,OR3=-0.035),nocturnal systolic blood pressure decrease(OR1=—0.344,OR2=-0.334,OR3=-0.322),nocturnal diastolic blood pressure decrease(OR1=-0.179,OR2=-0.388,OR3=-0.399)were independent risk factors for MCI occurred(P<0.05),clinical blood pressure did not entering regression model.Conclusion Cognitive impairment in elderly population is related to 24h ambulatory blood pressure parameters,which may not be related to clinical blood pressure.