正常眼压性青光眼患者认知功能损害及相关因素分析

发布时间：2018-03-25 11:55

本文选题：认知障碍　切入点：正常眼压性青光眼　出处：《中国全科医学》2014年35期

【摘要】：目的探讨正常眼压性青光眼(NTG)患者认知功能损害发生情况及相关影响因素。方法选取2011年6月—2014年1月在北京大学第三医院眼科门诊就诊的NTG患者41例,记录其一般资料,并进行汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)、蒙特利尔认知评估量表(Mo CA)等检测。结果根据Mo CA量表检测结果,将患者分为伴认知功能损害组(27例)和不伴认知功能损害组(14例)。认知功能损害发生率为65.8%(27/41)。两组患者性别、吸烟、饮酒、文化程度、睡眠障碍史、失眠家族史、打鼾、高脂血症、糖尿病、冠心病、脑血管疾病、胃肠道疾病、焦虑、抑郁发生率比较,差异均无统计学意义(P0.05);两组患者年龄、BMI、高血压、睡眠障碍发生率比较,差异有统计学意义(P0.05)。Logistic回归分析结果显示,年龄、BMI及PSQI是NTG伴认知功能损害的危险因素(P0.05)。NTG伴认知功能损害患者Mo CA总分为(22.5±2.4)分,各项目评分较参考值下降程度比较,差异有统计学意义(F=17.99,P0.05),其中记忆功能评分较参考值下降程度均高于其他项目评分较参考值下降程度(P0.05)。将各项目评分较参考值下降程度与年龄、PSQI、BMI进行相关分析,结果显示,各项目评分较参考值下降程度与年龄均无直线相关关系(r=0.219、0.172、0.008、0.046、0.349、-0.137、0.118、0,P0.05);记忆功能、视空间功能、执行功能、注意力、语言功能、时间定向力、地点定向力与PSQI均无直线相关性(r=0.141、0.171、-0.035、-0.027、-0.093、-0.275、0,P0.05),计算力、注意力和短期记忆力与PSQI呈正相关(r=0.410,P=0.042);记忆功能、视空间功能、执行功能、注意力、语言功能、时间定向力、地点定向力与BMI均无直线相关性(r=0.042、-0.011、0.192、0.038、0.168、-0.141、0,P0.05),计算力、注意力和短期记忆力与BMI呈正相关(r=0.432,P=0.031)。结论 NTG伴认知功能损害发生率较高,增龄、睡眠障碍和肥胖可增加NTG患者伴发认知功能损害的风险,并以记忆功能损害更为显著。
[Abstract]:Objective to investigate the occurrence of cognitive impairment in patients with normal intraocular pressure glaucoma (NTG) and its related influencing factors. Methods 41 patients with NTG from June 2011 to January 2014 were selected and their general data were recorded. Hamilton anxiety scale (Hamilton anxiety scale), Hamilton Depression scale (Hamd), Pittsburgh Sleep quality Index (PSQI), Montreal Cognitive Assessment scale (Montreal Cognitive Assessment scale) and so on. The patients were divided into two groups: the cognitive impairment group (n = 27) and the non-cognitive impairment group (n = 14). The incidence of cognitive impairment was 65.8 / 27 / 41. Gender, smoking, alcohol consumption, education, sleep disorder, family history of insomnia, snoring were observed in the two groups. There was no significant difference in the incidence of hyperlipidemia, diabetes, coronary heart disease, cerebrovascular disease, gastrointestinal diseases, anxiety and depression. The difference was statistically significant (P 0.05). Logistic regression analysis showed that age and PSQI were the risk factors of NTG with cognitive impairment. The total score of Mo CA in patients with NTG with cognitive impairment was 22. 5 卤2. 4, and the scores of each item were lower than those of reference. The difference was statistically significant (P < 0.05), in which the scores of memory function were lower than those of other items than those of reference values (P 0.05). The correlation analysis was carried out between the decline of scores compared with the reference values and the age of PSQI BMI, the results showed that there was no significant difference between the scores of each item and the age of PSQI BMI, the results showed that the scores of each item were significantly lower than those of the reference values. There was no linear correlation between the degree of decline of the scores compared with the reference value and the age. There was no linear correlation between r 0.219 / 0.1720.008 / 0.046n 0.349U -0.1370.118U / P 0.05s; memory function, visual and spatial function, executive function, attention function, language function, time orientation, location orientation and PSQI have no linear correlation rr 0.141U 0.171n -0.03N -0.02793U -0.02793n -0.275U P0.05. Attention and short-term memory were positively correlated with PSQI. There was no linear correlation between memory function, visual and spatial function, executive function, attention function, language function, time orientation, location orientation and BMI. There was a positive correlation between attention and short-term memory and BMI. Conclusion the incidence of cognitive impairment in patients with NTG is higher. Age, sleep disorder and obesity may increase the risk of cognitive impairment in NTG patients, and memory impairment is more significant.
【作者单位】：北京大学第三医院神经内科;河北省唐山市工人医院神经内二科;北京大学第三医院眼科;北京大学公共卫生学院;北京大学第三医院全科医学教研室;
【分类号】：R775

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