低血压对老年人认知功能的影响  

Effect of hypotension on cognitive function in elderly people

作　　者：黄海侠[1] 冯占辉[1] 刘芳[1] 刘伟民[2] 

机构地区：[1]贵阳医学院附属医院神经内科,550004 [2]贵阳市第一人民医院神经内科

出　　处：《中华老年心脑血管病杂志》2013年第2期164-167,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨低血压对老年人认知功能的影响。方法选择因头晕、头昏、乏力就诊的患者141例,通过问诊了解既往血压>5年的老年低血压患者(低血压组)67例,老年正常血压者(正常血压组)74例,所有受试者行蒙特利尔认知评估量表(MoCA)和简易智能状态检查量表(MMSE)检测,以及头颅MRI和颈部血管超声检查。结果多因素logistic回归分析显示,低血压是认知功能障碍的危险因素(P=0.020)。与正常血压组比较,低血压组的MoCA、MMSE评分明显降低(P=0.000),MoCA的视空间与执行功能、注意、语言、抽象、延迟回忆评分明显降低,差异有统计学意义,MoCA和MMSE评分呈正相关(r=0.922,P<0.05)。与正常血压组比较,低血压组脑白质损害分级显著升高(P<0.01)。两组颈部血管超声比较差异无统计学意义(P>0.05)。结论低血压是认知功能障碍的危险因素,老年低血压患者认知功能较正常血压者下降。Objective To study the effect of hypotension on cognitive function in elderly people. Methods One hundred and forty-one patients who visited our hospital due to dizziness, vertigo and fatigue were enrolled in this study. The patients with a hypotension history for over 5 years were divided into hypotension group（n= 67） and normal blood pressure group（n= 74）. The pa- tients underwent MoCA,MMSE,head MRI and cervical vascular ultrasonography. Results Mult- ivariate logistic regression analysis showed that hypotension was a risk factor for cognitive impair- ment（P = 0. 020）. The MoCA, MMSE, MoCA visual space, executive function, attention, lan- guage,abstraction,and delayed recall scores were significantly lower in hypotension group than in normal blood pressure group（P=0. 000）. The MoCA score was positively related with the MMSE score（r=0. 922 ,P〈0.05）. The white matter lesion classification was significantly higher in nor- mal blood pressure group than in hypotension group（P〈0.01）. No significant difference was ob- served in cervical vascular ultrasonography between the two groups（P〈0.05）. Conclusion Hy- potension is a risk factor for cognitive impairment. The cognitive function is lower in elderly pa- tients with hypotension than in those with a normal blood pressure.

关 键 词：低血压 血压测定 认知障碍 神经心理学测验 回归分析 磁共振成像 危险因素 

分 类 号：R749.1[医药卫生—神经病学与精神病学]