社区老年人群的颈动脉内膜中层厚度与认知功能障碍的相关研究

Association between carotid intima-media thickness and cognitive impairment in community elderly people

目的探讨老年人颈动脉内膜中层厚度(CIMT)与认知功能障碍的关系。方法纳入2010年北京市万寿路街道常住的年龄≥60岁的老年居民共1402例,根据CIMT水平分为正常组688例、增厚组611例和斑块组103例;又根据简易智能状态检查量表(MMSE)评分分为非认知功能障碍1139例(非认知障碍组)和认知功能障碍263例(认知障碍组)。患者均行颈动脉超声检查、MMSE评估、日常生活活动能力量表(ADL)评估、踝肱指数(ABI)检测,采用Pearson相关分析和多因素logistic回归分析。结果增厚组ABI和MMSE低于正常组(P<0.01)、ABI高于斑块组(P<0.05);认知障碍组CIMT高于非认知障碍组,ABI、MMSE和ADL低于非认知障碍(P<0.05,P<0.01)。CIMT与MMSE呈负相关(r=-0.342,P<0.05),ABI和ADL与MMSE呈正相关(r=0.213、0.202,P<0.05)。CIMT是老年人发生认知功能障碍的独立影响因素(OR=0.832,95%CI:0.610~1.394,P=0.027)。结论近半社区老年人群的CIMT增厚,CIMT与认知功能有关,对认知功能障碍的发生具有预测价值。

Objective To study the association between CIMT and cognitive impairment in community elderly people.Methods A total of 1402 ≥60 years old elderly people in Wanshoulu community were divided into control group(n=688),thicker CIMT group(n=611) and plaque formation group(n=103) according to their CIMT or cognitive impairment-free group(n=1139) and cognitive impairment group(n=263) according to their MMSE scale score.Their MMSE scale score,ADL score and ABI were recorded by ultrasonography and analyzed by Pearson correlation analysis and multivariate logistic regression analysis respectively.Results The ABI and MMSE scale score were significantly lower in thicker CIMT group than in control group(P<0.05) while the ABI was significantly higher in thicker CIMT group than in plaque formation group(P<0.05).The CIMT was thicker while the ABI,MMSE scale score and ADL score were lower in cognitive impairment group than in cognitive impairment-free group(P<0.05,P<0.01).The CIMT was negatively associated with the MMSE scale score(r=-0.342,P<0.05) while the ABI and ADL score were positively associated with the MMSE scale score(r=0.213,r=0.202,P<0.05).The CIMT was an independent risk factor for cognitive impairment in community elderly people(OR=0.832,95%CI:0.610-1.394,P=0.027).Conclusion The CIMT is thicker in about 1/2 community elderly people and is negatively associated with the MMSE scale score,and plays a role in predicting the cognitive impairment in community elderly people.