慢性心衰住院患者的认知功能特点及其影响因素

Characteristics and influencing factors of cognitive function in hospitalized patients with the chronic heart failure

目的:评估慢性心力衰竭(chronic heart failure,CHF)住院患者的认知功能特点及其影响因素。方法:方便取样北京市5所医院住院的104例CHF住院患者为研究对象,采用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)北京版进行认知功能测评。结果:CHF住院患者的认知功能障碍发生率为71.2%,各领域异常率从高到低分别为延迟回忆(92.3%)、视空间与执行功能(85.6%)、语言(76.0%)、抽象(57.7%)、注意(27.9%)、命名(2.9%)和定向力(0.0%)。多元线性回归分析显示,年龄(B=-0.024,P=0.027)和受教育年限(B=0.117,P=0.000)进入视空间与执行功能回归的方程;睡眠总分(B=-0.036,P=0.037)进入延迟记忆的方程;受教育年限(B=0.088,P=0.000)和睡眠总分(B=-0.038,P=0.022)进入注意的方程;年龄(B=-0.015,P=0.042)和受教育年限(B=0.047,P=0.019)进入抽象的方程;受教育年限(B=0.074,P=0.001)进入语言的方程;年龄(B=-0.067,P=0.029)、受教育年限(B=0.273,P=0.001)和NYHA分级(B=-0.915,P=0.017)进入MoCA总分的方程。结论:CHF住院患者认知功能障碍率较高,以延迟回忆受损最为明显。年龄、睡眠障碍、NYHA分级越高可能是慢性心衰患者发生认知功能障碍的独立危险因素,而受教育年限高是慢性心衰患者发生认知功能障碍的保护因素。

Objective:To investigate the cognitive function and influential factors of hospitalized patients with the chronic heart failure(CHF). Methods:A total of 104 CHF patients were conveniently drawn from patients in 5 hospitals and were evaluated by Montreal cognitive assessment scale(MoCA)Beijing Edition. Results:The prevalence of the cognitive impairment in 104 CHF patients in this study was 71.2%. The abnormal rates in each field ranking from high to low were delayed recall(92.3%),visual space and executive function(85.6%),language(76.0%),abstract(57.7%),attention(27.9%),naming(2.9%)and orientation(0.0%). The multivariate liner regression analysis indicated age(B=-0.024,P=0.027)and education years(B=0.117,P=0.000)into the equation of visual space and executive function,sleep score(B=-0.036,P=0.037)into the equation of delayed recall,education years(B=0.088,P=0.000)and sleep score(B=-0.038,P=0.022)into the equation of attention,age(B=-0.015,P=0.042)and education years(B=0.047,P=0.019)into the equation of abstract,education years(B=0.074,P=0.001)into the equation of language,age(B=-0.067,P=0.029),education years(B=0.273,P=0.001)and NYHA grades(B=-0.915,P=0.017)into the equation of MoCA score. Conclusion:The prevalence of cognitive impairment in CHF patients was relatively high,especially the delayed recall impairment. Age,sleep disorders,and higher NYHA grades may be independent risk factors for cognitive impairment in patients with chronic heart failure,and higher education was a protective factor for cognitive impairment in CHF patients.