军队离退休老年高血压患者认知功能障碍的危险因素

发布时间：2018-10-09 16:18

【摘要】：目的探讨军队离退休老年高血压患者认知功能障碍发生的相关危险因素。方法对长期坚持降压治疗的军队离退休老年原发性高血压患者162例进行调查,行颈部血管超声、头颅CT或MRI检查,以简易智能精神状态量表(MMSE)进行认知功能评估。根据MMSE评分将患者分为认知功能障碍组(n=73)和认知功能正常组(n=89)。采用Logistic回归分析筛选认知功能障碍的影响因素。结果与认知功能正常组相比,认知功能障碍组高血压病程较长[(23.9±6.8)比(15.9±7.6)年,P0.01],血同型半胱氨酸水平、颈动脉内膜中层厚度(IMT)增加[(22.12±5.16)比(17.11±3.87)μmol/L,(1.12±0.14)比(1.01±0.15)mm,均P0.01],颈动脉粥样硬化、脑梗死、皮层下动脉硬化性脑病、脑萎缩检出率较高(分别为60.27%比6.74%,97.26%比74.16%,79.45%比19.10%,86.30%比55.06%,均P0.01)。多因素非条件Logistic回归分析结果显示,高血压病程、血同型半胱氨酸水平、颈动脉粥样硬化及皮层下动脉硬化性脑病是本组军队离退休老年高血压患者发生认知功能障碍的危险因素,OR(95%CI)分别为3.65(1.57~8.52)、16.70(4.02~69.39)、76.69(10.82~543.86)和24.25(6.03~97.49),均P0.01。结论在坚持长期降压治疗的军队离退休老年高血压患者中,高血压病程长、伴有高同型半胱氨酸血症、颈动脉粥样硬化及皮层下动脉硬化性脑病的人更容易发生认知功能障碍。
[Abstract]:Objective to investigate the risk factors of cognitive dysfunction in retired elderly hypertensive patients. Methods 162 elderly patients with essential hypertension who had been treated with hypotensive therapy for a long time were investigated. Cervical vascular ultrasound, head CT or MRI were performed, and cognitive function was evaluated by simple Mental State scale (MMSE). According to the MMSE score, the patients were divided into two groups: cognitive impairment group (NM73) and normal cognitive function group (NM89). The influencing factors of cognitive dysfunction were screened by Logistic regression analysis. Results the duration of hypertension in cognitive dysfunction group was longer than that in normal cognitive function group [(23.9 卤6.8) vs (15.9 卤7.6) years, P 0.01], the plasma homocysteine level, carotid intima-media thickness (IMT) were increased [(22.12 卤5.16) 渭 mol/L, vs (17.11 卤3.87) 渭 mol/L, vs (1.01 卤0.15) mm, P 0.01], carotid atherosclerosis, cerebral infarction, carotid artery atherosclerosis, cerebral infarction, carotid artery atherosclerosis, cerebral infarction, carotid atherosclerosis, cerebral infarction. The positive rate of cerebral atrophy was higher in subcortical arteriosclerotic encephalopathy (60.27% vs 6.74% 97.26% vs 74.16% 79.45% vs 19.106.30% vs 55.06%, all P 0.01). Multivariate conditional Logistic regression analysis showed that the course of hypertension, serum homocysteine level, Carotid atherosclerosis and subcortical arteriosclerotic encephalopathy were the risk factors of cognitive dysfunction in retired elderly hypertensive patients. The OR (95%CI) were 3.65 (1.578.52) and 16.70 (4.02 ~ 69.39), respectively, 76.69 (10.82n 543.86) and 24.25 (6.0397.49), respectively (P 0.01). Conclusion among the retired elderly hypertensive patients who insist on long-term hypotensive therapy, the patients with hypertension with hyperhomocysteinemia, carotid atherosclerosis and subcortical arteriosclerotic encephalopathy are more likely to develop cognitive dysfunction.
【作者单位】：解放军第451医院干部病房;第四军医大学西京医院老年病科;第四军医大学流行病学教研室;
【基金】：卫生部行业基金科研专项(201002011)
【分类号】：R544.1;R749.1

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