同等肾功能下老年人认知功能障碍与血肌酐水平的关系

发布时间：2018-05-11 17:40

  本文选题：认知障碍 + 血肌酐　； 参考：《中国全科医学》2017年15期

【摘要】：背景肾功能与认知功能之间的关系尚存争议,影响老年人认知功能障碍(CI)的因素众多,血肌酐(Scr)与老年人CI的相关性鲜见报道。目的探讨同等肾功能下老年人CI与Scr水平的关系,以期为老年人CI的临床治疗提供理论基础和诊疗依据。方法 2014~(-1)1~(-1)3至2014~(-1)2-21采用分层随机抽样法在江苏省如皋市江安镇31个村选取符合纳入标准的1 757例老年人为研究对象。收集受试者一般资料;采用改良长谷川痴呆量表(HDS-R)进行认知功能评价,按照HDS-R总分,21.5分为无认知功能障碍(NCI),≤21.5分为CI;记录实验室检查结果[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、Scr水平及估算肾小球滤过率(e GFR)],根据e GFR对受试者进行肾功能分级:Ⅰ级,肾功能正常,e GFR≥90 ml·min~(-1)·(1.73m~2)~(-1);Ⅱ级,肾功能轻度损伤,60 ml·min~(-1)·(1.73 m~2)~(-1)≤e GFR90 ml·min~(-1)·(1.73 m~2)~(-1);≥Ⅲ级,肾功能中重度损伤,e GFR60 ml·min~(-1)·(1.73 m~2)~(-1)。结果 1 757例受试者中,男820例,女937例;平均年龄(75.3±3.9)岁;NCI者823例,CI者934例;肾功能分级:Ⅰ级275例(NCI者154例,CI者121例);Ⅱ级1 001例(NCI者513例,CI者488例);≥Ⅲ级481例(NCI者156例,CI者325例)。Ⅰ级肾功能下,NCI者男性率、Scr水平高于CI者,脑卒中发生率、冠心病发生率、TG水平低于CI者(P0.05)。Ⅱ级肾功能下,NCI者男性率、Scr水平高于CI者,年龄小于CI者,TG水平低于CI者(P0.05)。≥Ⅲ级肾功能下,NCI者男性率、Scr水平高于CI者,年龄小于CI者(P0.05)。Ⅰ级肾功能下,HDS-R总分与Scr水平呈正相关(r=0.506,P0.001);Ⅱ级肾功能下,HDS-R总分与Scr水平呈正相关(r=0.444,P0.001);≥Ⅲ级肾功能下,HDS-R总分与Scr水平呈正相关(r=0.233,P0.001)。结论同等肾功能下,高水平Scr对老年人CI具有一定的保护作用,且在肾功能良好情况下作用效果更显著。
[Abstract]:Background the relationship between renal function and cognitive function remains controversial, and there are many factors affecting the cognitive dysfunction of the elderly. The correlation between serum creatinine (SCR) and CI in the elderly is rarely reported. Objective to explore the relationship between CI and Scr in elderly patients with the same renal function, and to provide theoretical basis and basis for diagnosis and treatment of CI in elderly patients. Methods the stratified random sampling method was used to select 1 757 elderly people in 31 villages of Jiangan Town, Rugao City, Jiangsu Province. The general data of the subjects were collected, and the cognitive function was evaluated with the modified Hasegawa dementia scale (HDS-RV). According to the HDS-R total score of 21.5, divided into no cognitive impairment, 鈮，

本文编号：1874923