老年H型高血压与认知功能障碍的关系  

Relationship Between H-type Hypertension and Cognitive Impairment in Elderly Patients

作　　者：王晓楠[1] 白小涓[1] 齐国先[1] 王春雷[1] 单海燕[1] 

机构地区：[1]中国医科大学附属第一医院老年病科,辽宁省沈阳市110001

出　　处：《中国动脉硬化杂志》2013年第10期894-898,共5页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金资助项目(81200246);高等学校博士学科点专项科研基金(20122104120004)

摘　　要：目的 探讨老年原发高血压伴有血浆同型半胱氨酸增高（H型高血压）与认知功能障碍的关系。方法选择2011年8月～2013年2月在中国医科大学附属第一医院老年病科住院的原发高血压患者150例，根据血浆同型半胱氨酸（Hcy）的检测值分为非H型高血压组（Hcy＜10 μmol/L）40例，H型高血压1组（10 μmol/L≤Hcy＜20 μmol/L）60例，H型高血压2组（Hcy≥20 μmol/L）50例。采用简易精神状态量表（MMSE），蒙特利尔认知评估中文版（MoCA）和日常生活能力量表对各组患者进行认知功能评定。根据MMSE评分及日常生活能力量表评分，将H型高血压患者分为认知功能正常组22例，轻度认知功能障碍组54例，及认知功能障碍组34例。结果 与非H型高血压组相比较，H型高血压1组及H型高血压2组的空腹血糖、餐后2 h血糖、血浆Hcy及血尿酸水平显著升高，MMSE评分及MoCA评分降低；与H型高血压1组相比较，H型高血压2组的血肌酐、餐后2 h血糖及血浆Hcy水平显著升高，MMSE评分及MoCA评分降低。老年H型高血压患者MoCA评分与餐后2 h血糖及血浆Hcy水平呈显著负相关。结论 老年H型高血压患者更易发生认知功能损害，且认知功能损害的程度与血浆Hcy水平呈正相关。Aim To study the relationship between H-type hypertension and cognitive impairment in elderly patients. Methods 150 elderly essential hypertension patients were selected from the Department of Gerontology and Geriatrics of the First Affiliated Hospital of China Medical University between August 2011 and February 2013. According to the plasmatic homocysteine （Hcy） levels the elderly essential hypertension patients were divided into 3 groups （none H-type hypertension group： Hcy〈10 μmol/L 40 patients H-type hypertension group 1：10 μmol/L≤Hcy〈20 μmol/L 60 patients H-type hypertension group 2： Hcy≥20 μmol/L 50 patients）. The mini-mental state examination （MMSE）,Montreal cognitive assessment （MoCA） and the activities of daily living （ADL） were used to evaluate the cognitive function. According to the MMSE score and ADL score,the H-type hypertension patients were divided into 3 groups （control group,22 patients mild cognitive impairment （MCI） group,54 patients cognitive impairment （CI） group,34 patients）.Results In comparison to none H-type hypertension group,fasting blood glucose （FBG）,postprandial blood glucose （PBG）,Hcy and uric acid （UA） levels increased significantly,and MMSE score and ADL score decreased significantly in H-type hypertension group 1 and H-type hypertension group 2. In comparison to H-type hypertension group 1,creatinine （Cr）,PBG and Hcy levels increased significantly,and MMSE score and ADL score decreased significantly in H-type hypertension group 2. There is a negative correlation between the score of MoCA and plasmatic Hcy level in elderly H-type hypertension patients. Conclusion Elderly patients with H-type hypertension have higher risk for cognitive impairment,and higher plasma Hcy level,the more severe the cognition impaired.

关 键 词：H型高血压 同型半胱氨酸 认知功能障碍 

分 类 号：R5[医药卫生—内科学]