高血压患者体质类型与认知障碍相关性研究

Study on Correlation Between Constitution Types and Cognitive Impairment in Patients with Hypertension

目的:探讨高血压伴认知障碍(CI)患者的体质分布情况及CI的影响因素。方法:纳入3799例高血压患者,分为CI组和无认知障碍(NCI)组,记录两组患者一般资料(年龄、性别、文化程度、婚姻状态、工作类型、烟酒史等)、实验室指标(空腹血糖、血脂、血肌酐等)水平、量表[简易智力状态检查量表(MMSE)、匹兹堡睡眠质量指数量表(PSQI)、中医体质类型量表]评分等信息。以体质类型为主要监测指标,分析高血压伴CI患者体质类型分布状况。结果:3799例高血压患者中有506例(13.32%)被纳入CI组。CI组患者年龄、年龄大于60岁人群比例、女性比例、文化程度在初中以下人群比例、工作类型以体力劳动为主人群比例、3级高血压人群比例、有睡眠障碍人群比例、高血压病程、血肌酐水平显著高于NCI组(P<0.05);汉族人群比例、吸烟人群比例、饮酒人群比例、体质量指数(BMI)及甘油三酯、胆固醇、低密度脂蛋白(LDL)水平低于NCI组(P<0.05)。CI组气虚质患者人数最多,NCI组平和质患者人数最多。偏颇质高血压患者的定向、记忆、计算、回忆、命名、阅读、执行、书写认知功能比平和质高血压患者更差(P<0.05)。Logistic回归分析显示,体质类型是CI发病的影响因素,气虚质、气郁质与CI发生相关。年龄大于60岁、文化程度低、汉族以外的其他民族、存在睡眠障碍、LDL水平低与CI发生有关。结论:不同中医体质的高血压患者CI发病倾向不同,气虚质、气郁质与CI发生相关,此类体质者应从“体病相关”理论出发,采取相应预防措施。

Objective:To explore the distribution of traditional Chinese medicine(TCM)constitution in patients with hypertension accompanied by cognitive impairment(CI)and the influencing factors of CI.Methods:A total of 3799 patients with hypertension were included and divided into CI group and non-cognitive impairment(NCI)group.The general infor-mation(age,gender,education level,marital status,occupation type,smoking and alcohol history,etc.),laboratory indicators(fasting blood glucose,blood lipid,serum creatinine,etc.),and scores from scales[mini-mental state examination(MMSE),Pittsburgh sleep quality index(PSQI),TCM constitution type scale]of both groups were collected.Taking TCM constitution as the main monitoring index,the distribution of TCM constitution in patients with hypertension accompanied by CI was analyzed.Results:Among the 3799 patients with hypertension,506(13.32%)were included in the CI group.The age,proportion of individuals aged over 60 years,proportion of females,proportion of individuals with education level below junior high school,proportion of individuals engaged in physical labor as their primary occupation,proportion of individuals with grade 3 hypertension,proportion of individuals with sleep disorders,course of hypertension,and serum creatinine levels in the CI group were significantly higher than those in the NCI group(P<0.05).The proportion of Han population,proportion of smokers,proportion of drinkers,body mass index(BMI),as well as levels of triglycerides,cholesterol,and low-density lipoprotein(LDL)were lower in the CI group compared to the NCI group(P<0.05).The number of patients with qi deficiency constitution is the highest in the CI group,while the number of patients with balanced constitution is the highest in the NCI group.Hypertension patients with biased constitution had poorer cognitive functions in terms of orientation,memory,calculation,recall,naming,reading,execution,and writing compared to hypertension patients with balanced constitution(P<0.05).The results of Logistic regression analysis showed that TCM constitution type was an influencing factor for CI,and qi deficiency constitution and qi stagnation constitution were the susceptible constitutions of CI.Being over 60 years old,having a low level of education,belonging to ethnic groups other than Han Chinese,experiencing sleep disorders,and having a low LDL level were associated with the occurrence of CI.Conclusions:Hypertension patients with different TCM constitutions have different tendencies for CI.Qi deficiency constitution and qi stagnation constitution are associated with the occurrence of CI.Individuals with these constitutions should adopt corresponding preventive measures based on the theory of“constitution-disease correlation”.