体位性低血压对老年人认知功能损害的队列研究  

Orthostatic hypotension predicts cognitive impairment in the elderly： findings from a cohort study

作　　者：黄海侠[1] 刘芳[2] 郑天衡[1] 吴卓丽 杨建道[1] 肖晶晶[1] 王少石[1] 

机构地区：[1]上海市第一人民医院分院神经内科,200081 [2]贵州医科大学附属医院神经内科,贵阳550001

出　　处：《中华神经医学杂志》2016年第12期1274-1278,共5页Chinese Journal of Neuromedicine

基　　金：上海市虹口区鼓励课题（虹卫1203-01）

摘　　要：目的探讨体位性低血压（OH）与老年人认知障碍（CI）的关系。方法选择自2009年1月至2011年12月因头昏、头晕、乏力在上海市第一人民医院分院神经内科就诊的44名OH老年患者为OH组，按1：2配对88名正常血压老年人志愿者为对照组。收集2组研究对象一般人口学资料及认知相关影响因素，4年后采用简易精神状态检查表（MMSE）对所有研究对象行CI诊断。结果在114名完成随访评估的研究对象中，共有16人诊断为CI，发生率为14．0％，其中OH组CI发生率为23．7％，对照组CI发生率为9．2％，差异有统计学意义（χ2=4．399，P=-0．036）。分层分析结果显示，年龄〈70岁的患者中0H组CI发生率为15．4％，与对照组CI发生率（9．1％）差异无统计学意义（P〉0．05）；年龄≥70岁的患者中OH组CI发生率（41．7％）显著高于非OH（9.3％），差异有统计学意义（χ2=5．935，P=0．016）。结论OH可导致70岁以上老年人认知损害。Objective To explore the relationship between orthostatic hypotension （OH） and cognition impairment （CI） in the elderly. Methods Forty-four OH patients who visited our hospital due to dizziness, vertigo and fatigue during January 2009 to December 2011 were enrolled in the exposed group （OH group）, and 88 healthy elderly paired in 1：2 were enrolled in the control group （NOH group）. The socio-demographic data and cognition-related factors between the two groups were collected at baseline; cognitive function was assessed using mini-mental state examination （MMSE） 4 years after baseline of the present study. Results The overall incidence of CI was 14.0% among the 114 subjects who completed the follow-up assessment. Significant difference in CI incidence was noted between OH group （23.7%） and NOH group （9.2%,χ2=4.399, P=0.036）. The analysis by age showed that there was no significant difference in CI incidence between the OH group （15.4%） and NOH group （9.1%） among the elderly younger than 70 years; the CI incidence in OH group （41.7%） was significantly higher than that in NOH group （9.3%） among the elderly older than 70 years （χ2=-5.935, P=-0.016）. Conclusion OH is a risk factor of CI among the elderly older than 70 years.

关 键 词：体位性低血压 认知损害 老年人 队列研究 

分 类 号：R749.2[医药卫生—神经病学与精神病学]