慢性阻塞性肺疾病患者急性加重期认知功能障碍相关因素分析  

Relating factors analysis of cognition dysfunction in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：王兰[1] 江莲[1] 唐良法[1] 侯昕珩[1] 赵洪达[1] 许群[1] 周丽琴[1] 

机构地区：[1]江苏省江阴市人民医院呼吸内科,214400

出　　处：《中华老年医学杂志》2015年第4期391-393,共3页Chinese Journal of Geriatrics

摘　　要：目的 探讨慢性阻塞性肺疾病急性加重期（AECOPD）住院患者认知功能障碍的相关因素.方法 对年龄、性别相匹配的150例AECOPD住院患者及150例健康对照者进行认知功能评分和抑郁评分,将AECOPD患者分为认知功能障碍组和无认知功能障碍组,测定所有患者空腹血尿酸水平并进行比较,同时对认知功能障碍的相关因素进行分析.结果 AECOPD组中文版蒙特利尔认知评估量表（MoCA）评分（19.01±3.58）分,较对照组（26.58±1.42）分明显下降,差异有统计学意义（t=-3.48,P=0.032）;AECOPD组汉密尔顿抑郁量表（HAMD）评分为（18.05±4.50）分,对照组为（9.98±3.51）分,两组比较差异有统计学意义（t=4.63,P=0.028）.AECOPD组中82例存在认知功能障碍,血尿酸（235±42）μmol/L,明显低于无认知功能障碍组68例（332±45） μmol/L（t=-6.65,P=0.003）.AECOPD患者的认知功能与受教育水平、住院时间、血尿酸、COPD分级、病程和抑郁程度有关,与吸烟、体质指数则无相关性.结论 AECOPD患者认知功能障碍发生率较高,且与低血尿酸水平、更长的住院时间和疾病严重程度有关.Objective To explore the relating factors for cognitive dysfunction in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.Methods Totally 150 patients with acute exacerbation of COPD （AECOPD） and 150 gender and age-matched healthy subjects （controls） received the cognitive and depression function assessment.150 AECOPD cases were classified into two groups：COPD patients with or without cognitive dysfunction.Fasting blood uric acid （UA） was measured and compared between the two groups.Relating factors for cognition dysfunction were analyzed.Results The score of Montreal Cognitive Assessment （MoCA） was reduced in AECOPD patients as compared with controls [（19.01±3.58） vs.（26.58±1.42）scores,t=-3.48,P=0.032].The score of Hamilton depression （HAMD） scale was higher in AECOPD patients than in controls [（18.05 ± 4.50） vs.（9.98 ± 3.51） scores,t =4.63,P =0.028].The prevalence of cognitive impairment in the patients with AECOPD was 82 cases （54.7%）.The serum UA level was lower in the AECOPD patients with cognitive impairment than in patients without cognitive impairment [（235±42） μmol/L （n=82） vs.（332±45） μmol/L （n=68）,t=-6.65,P=0.003].In AECOPD patients,the cognitive function was correlated with education,length of hospital stay,serum UA level,COPD stages,disease duration and the depression level,but was not correlated with smoking and body mass index.Conclusions The cognitive impairment is highly prevalent in patients with AECOPD,which is associated with lower serum UA level,longer hospital stay and disease severity.

关 键 词：肺疾病 慢性阻塞性 认知障碍 尿酸 

分 类 号：R563.9[医药卫生—呼吸系统]