LVEF值与老年脑小血管病伴血管性认知障碍的相关性分析

Correlation between LVEF and vascular cognitive impairment in elderly patients with small vessel disease

目的分析左室射血分数(LVEF)值与老年脑小血管病(cerebral small vessel disease, CSVD)伴血管性认知障碍(vascular cognitive impairment, VCI)的相关性。方法回顾性分析我院2018年6月~2020年9月收治的85例老年CSVD患者的临床资料,依据蒙特利尔认知量表(MoCA)及Hachinski缺血评分表(HIS)分为CSVD伴VCI组(MoCA评分<26分、HIS≥7分,n=40)与CSVD组(MoCA评分≥26分、HIS<7分,n=45)。收集所有患者基础资料,包括年龄、性别、受教育年限、民族、身体质量指数(BMI)、是否合并高血压、是否合并糖尿病、是否吸烟、是否饮酒、收缩压(SBP)、舒张压(DBP)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、腔隙性脑梗死数目(LI)各项信息。对比两组基础资料信息差异,将有差异信息纳入Logistic模型,行量化赋值,以是否发生VCI为因变量(Y),以年龄、受教育年限、合并高血压、合并糖尿病、吸烟、饮酒、LVEF、LVEDD、LI为自变量(X),明确老年CSVD患者发生VCI的危险因素。结果两组性别、民族、BMI、SBP、DBP对比无显著差异,P>0.05;CSVD伴VCI组年龄≥65岁、受教育年限≤9年、合并高血压、合并糖尿病、吸烟、饮酒、LVEF<50%、LVEDD>55 mm、LI>1个患者显著多于CSVD组,P<0.05。经多因素Logistic回归分析证实,年龄≥65岁、受教育年限≤9年、合并高血压、合并糖尿病、吸烟、饮酒、LVEF<50%、LVEDD>55 mm、LI>1个为老年CSVD患者发生VCI的危险因素,P均<0.05。结论老年CSVD患者发生VCI受到较多因素的影响,临床应予以相应治疗方式进行干预,以降低老年CSVD患者发生VCI的概率。

Objective To analyze the correlation between LVEF and vascular cognitive impairment(VCI) in elderly patients with cerebral small vessel disease(CSVD). Methods The clinical data of 85 elderly patients with CSVD admitted to our hospital from June 2018 to September 2020 were retrospectively analyzed. They were divided into CSVD with VCI group(MoCA<26, HIS≥7, n=40) and CSVD group(MoCA ≥ 26, HIS<7, n=45) according to Montreal Cognitive Scale(MoCA) and Hachinski ischemic scale(HIS). The basic data of all patients were collected, including age, gender, years of education, nationality, body mass index(BMI), hypertension, diabetes, smoking, drinking, systolic blood pressure(SBP), diastolic blood pressure(DBP), left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVEDD) and the number of lacunar infarction(LI). The differences of basic information between the two groups were compared, and the difference information was included in the Logistic model, and the quantitative assignment was performed. The occurrence of VCI was taken as the dependent variable(Y), and the age, years of education, hypertension, diabetes, smoking, drinking, LVEF, LVEDD, LI were taken as the independent variables(X). Results There was no significant difference in gender, nationality, BMI, SBP and DBP between the two groups(P>0.05);the age ≥65 years, education years ≤9 years, hypertension, diabetes, smoking, drinking, LVEF<50%, LVEDD>55 mm, LI>1 in CSVD with VCI group were significantly more than those in CSVD group(P<0.05). Multivariate logistic regression analysis showed that age ≥65 years old, education years ≤9 years, hypertension, diabetes, smoking, drinking, LVEF<50%, LVEDD>55 mm, LI>1 were risk factors for VCI in elderly patients with CSVD, all P<0.05. Conclusion The occurrence of VCI in elderly patients with CSVD is affected by many factors, and the corresponding treatment should be intervened to reduce the probability of VCI in elderly patients with CSVD.