老年高血压伴衰弱患者认知功能障碍的危险因素及与不良预后的关系

Risk factors of cognitive dysfunction and its relationship with poor prognosis in elderly hypertensive patients with frailty

目的:探讨老年高血压伴衰弱患者认知功能障碍的危险因素及与不良预后的关系。方法:选择2019年7月至2021年3月河北省第八人民医院收治的老年高血压伴衰弱患者150例,根据是否存在认知功能障碍分为认知正常组(92例)和认知障碍组(58例),收集两组患者一般资料、预后情况。采用多因素Logistic回归分析老年高血压伴衰弱患者认知功能障碍的危险因素,采用Spearman相关性分析法分析认知功能障碍程度与预后的相关性。结果:认知障碍组患者年龄较认知正常组大,存在糖尿病、冠心病、脑卒中、低钠血症、多重用药、营养不良的比例显著高于认知正常组(P<0.05或<0.01)。多因素Logistic回归分析显示,年龄≥75岁、脑卒中、多重用药、营养不良是老年高血压伴衰弱患者发生认知功能障碍的独立危险因素(OR=2.804~6.434,P<0.05或<0.01)。认知障碍组预后不良事件发生率显著高于认知正常组(51.72%比11.96%,P<0.001)。Spearman相关性分析显示,老年高血压伴衰弱患者认知功能障碍与不良预后呈显著正相关(r=0.435,P<0.001)。结论:年龄、脑卒中、多重用药、营养不良是老年高血压伴衰弱患者认知功能障碍的独立危险因素,认知功能障碍与此类患者不良预后密切相关。

Objective:To investigate the risk factors of cognitive dysfunction and its relationship with poor prognosis in elderly hypertensive patients with frailty.Methods:A total of 150 elderly hypertensive patients with frailty treated in Eighth People's Hospital of Hebei Province from July 2019 to March 2021 were selected.According to presence of cognitive dysfunction,they were divided into normal cognition group(n=92)and cognitive dysfunction group(n=58),and general data and prognosis condition were collected in two groups.Multivariate Logistic regression analysis was used to analyze the risk factors of cognitive dysfunction in elderly hypertensive patients with frailty;Spearman correlation analysis was used to analyze the correlation between cognitive dysfunction degree and prognosis.Results:Compared with normal cognition group,cognitive dysfunction group was significantly older and possessed significant higher proportions of diabetes,coronary heart disease,stroke,hyponatremia,multiple medication and malnutrition(P<0.05 or<0.01).Multivariate Logistic regression analysis indicated that age≥75 years,stroke,multiple medication and malnutrition were independent risk factors for cognitive dysfunction in elderly hypertensive patients with frailty(OR=2.804~6.434,P<0.05 or<0.01).Incidence rate of poor prognosis events in cognitive dysfunction group was significantly higher than that of normal cognition group(51.72%vs.11.96%,P<0.001).Spearman correlation analysis showed that cognitive dysfunction was significant positively correlated with poor prognosis in these patients(r=0.435,P<0.001).Conclusion:Age,stroke,multiple medication and malnutrition are independent risk factors for cognitive dysfunction in elderly hypertensive patients with frailty.Cognitive dysfunction is closely related to poor prognosis in these patients.