老年高血压伴轻度认知功能障碍的特点及相关临床危险因素

Analysis of the characteristics and associated clinical risk factors of hypertension with mild cognitive dysfunction in the elderly

目的探索老年高血压患者认知功能障碍特点及相关临床危险因素。方法选取2018年1月至2019年1月西安交通大学第一附属医院老年科60岁以上且未诊断为认知功能障碍或痴呆的住院高血压患者209例。对所有纳入人群进行简易智能状态检查量表(MMSE)评分,根据评分结果分为两组,即认知功能正常组110例;认知功能异常组99例,并分析两组患者在年龄、性别、文化程度、基础疾病、血红蛋白(Hb)、血小板数量、尿蛋白(PRO)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)、糖化白蛋白(GA)、糖化血红蛋白(HbA1c)、肌酐(Cr)、尿素氮(BUN)、肾小球滤过率、胱抑素(Cys)、D-二聚体(D-dimer)等因素之间的差异。结果年龄、ALB、GA、Cys、D-dimer、神经元特异性烯醇化酶(NSE)之间,两组差异有统计学意义。二元logistic回归提示:年龄、Cys是老年高血压发生认知功能障碍的危险因素(P<0.05)。结论年龄、Cys增高是老年高血压发生认知功能障碍的独立危险因素,其认知功能障碍的认知域损伤主要表现为计算力、时间和地点定向、画图、延迟回忆、造句、即刻记忆的认知受损。

Objective To explore the characteristics and related clinical risk factors of cognitive dysfunction in elderly hypertension patients.Methods From January 2018 to January 2019,two hundred and nine hypertension patients over 60-year old admitted to the Department of Geriatrics at the first affiliated hospital of Xi′an Jiao Tong University.Simple intelligence status examination scales were used to divide the hypertension patients into two groups,an abnormal cognitive function group(n=99)and a normal cognitive function group(n=110).Then the differences of age,gender,education level,underlying disease,hemoglobin,platelets,cystatin C,D-dimer and other factors between the two groups were analyzed.Results There were significant differences in age,plasma albumin,glycosylated hemoglobin,cystatin C,D-dimer and neuron-specific enolase between the two groups.Binary logistic regression analysis suggested that age and cystatin C level were risk factors for cognitive dysfunction in the elderly hypertension inpatients.Conclusions The prevalence rate of MCI gradually increased with age and Cys level,the predictive effects of calculation,orientation to time,orientation to location,drawing,delayed recall,sentence-making,and immediate memory on MCI are relatively signifcant.