老年高血压患者认知功能障碍与糖化血红蛋白的关系  

Relationship between cognitive impairment and serum HbAlc level in elderly hypertensive patients

作　　者：马孝湘[1] 王林[1] 程幼夫[1] 杨雁华[1] 龚瑜[1] 杨华[1] 刘玉萍[1] 

机构地区：[1]四川省医学科学院四川省人民医院健康管理中心,成都610072

出　　处：《中华老年心脑血管病杂志》2015年第7期689-692,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年高血压患者认知功能障碍与糖化血红蛋白（HbA1c）的关系。方法使用简易智能状态检查量表（MMSE）对115例老年高血压患者进行认知功能评分,根据诊断分为认知功能障碍组51例和认知功能正常组64例。比较2组年龄、性别、受教育年限、吸烟、饮酒、体质量指数、空腹血糖、餐后2 h血糖、TC、TG、LDL-C、HDL-C、尿酸、血肌酐、血尿素、收缩压和舒张压的差异,并进行logistic回归分析。结果认知功能障碍组受教育年限较认知功能正常组明显降低[（4.14±4.86）年vs（8.25±3.98）年,P〈0.05],HbA1c较认知功能正常组明显升高[（6.01±0.87）%vs（5.19±0.79）%,P〈0.05]。1ogistic回归分析显示,受教育年限（β=1.736,OR=10.654,95%CI：5.421-10,745,P=0.002）和HbA1c（β=1.038,OR=6.558,95%CI：1.369-6.541,P=0.004）进入回归方程,是认知功能障碍的独立影响因素。结论除受教育程度因素外,HbA1c是老年高血压患者的独立危险因素,积极控制HbA1c水平、减少高血糖,对保护老年高血压认知功能有着重要意义。Objective To study the relationship between cognitive impairment and serum HbAlc level in elderly hypertensive patients.Methods One hundred and fifteen elderly hypertensive patients were divided into cognitive impairment group（n = 51） and normal cognitive group（n = 64）according to their MMSE score.Their age,gender,education time（years）,smoking,drinking,BMI,serum FPG,2 h PG,TC,TG,LDL-C,HDL-C,UA,BUN and Scr levels,SBP and DBP were compared and analyzed by logistic regression analysis.Results The education time was significantly shorter while the serum HbAlc level was significantly higher in normal cognitive group than in cognitive impairment group（4.14 ± 4.86 years vs 8.25±3.98 years,P〈0.05;6.01%±0.87%vs 5.19%± 0.79%,P〈0.05）.Logistic regression analysis showed that education time and serum HbAlc level were the independent risk factors for cognitive impairment（β= 1.736,OR=10.654,P = 0.002;β=1.038,OR = 6.558,P = 0.004）.Conclusion Education time and serum HbAlc level are the independent risk factors for cognitive impairment in elderly hypertensive patients.Active control of serum HbAlc and blood glucose levels is thus of great importance for protection of cognitive function in elderly hypertensive patients.

关 键 词：高血压 认知障碍 血红蛋白A 糖基化 葡萄糖代谢障碍 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病] R749.2[医药卫生—内科学]