综合医院老年患者认知功能障碍及其影响因素分析  

Survey of cognitive dysfunction and influencing factors in elderly inpatients in geriatric department of general hospital

作　　者：姜玲[1] 朱昀[1] 张福春[1] Jiang Ling Zhu Yun Zhang Fuchun(Department of Geriatrics, Peking University Third Hospital, Beij ing 100191 , China)

机构地区：[1]北京大学第三医院老年内科,100191

出　　处：《中华老年医学杂志》2017年第10期1092-1096,共5页Chinese Journal of Geriatrics

摘　　要：目的了解综合医院老年患者认知功能情况，分析共病及其他因素对认知功能障碍的影响。方法人选老年内科住院患者205例，对所有患者采用简易智能评估量表（MMsE）筛查认知功能，分为认知功能正常组和认知功能障碍组，同时收集年龄、性别、文化程度、婚姻、职业、体育锻炼、居住情况、体质指数等一般情况，记录高血压、糖尿病、脑血管疾病、高脂血症、冠心病病史，所有患者抽血测量糖化血红蛋白（HbAlc）、游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、空腹血糖（FPG）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、尿素氮（BUN）、肌酐（Cr）、尿酸（UA）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST），动脉彩超测量颈动脉及下肢动脉斑块大小或狭窄程度，比较两组间差异，并应用非条件Logistic回归的方法探索各因素（包括共病）对认知功能障碍的影响。结果认知功能障碍组年龄、文化程度、婚姻状况、居住状态、高血压、糖尿病、脑血管病、糖化血红蛋白与认知功能正常组比较，差异有统计学意义（P=0．027、0．003、0．000、0．001、0．031、0．036、0．043、0．032）；应用Logistic回归分析结果显示，年龄增加、文化程度低、无配偶、合并糖尿病、脑血管病及共病会增加认知功能障碍的风险（OR=2．756、0．354、8．267、3．768、2．856、1．446，均P〈0．05）。结论认知功能障碍与年龄、文化程度、婚娴状况、糖尿病病史、脑血管病史、共病有关，其中年龄增加、文化程度低、无配偶、合并糖尿病、脑血管病及共病会增加认知功能障碍的风险。Objective To investigate the cognitive dysfunction of inpatients in geriatric department general hospital and to analyze the influencing factors. Methods A total of 205 patients hospitalized in Peking University Third Hospital were evaluated by mini mental state examination （MMSE）. All patients were divided into cognitive impairment group and non-cognitive impairment group. The general characteristics, prevalence, biochemistry indexes, eomorbidities, and color ultrasound detected plaque and stenosis in carotid arteries and artery of lower extremity were analyzed and compared between two groups. The logistic multiple regression analysis was used to explore the influencing factors of cognitive dysfunction. Results The differences in age（P=0. 027）,education （P=0.003）,marital status（P= 0.000）,living situation（P= 0.001）,hypertension history（P 0.031 ）, type 2 diabetes mellitus （T2DM） history （ P = 0. 036 ）, cerebrovascular disease history （ P 0. 043）and HbAlc （P = 0. 032） were statistically significant between cognitive impairment and non- cognitive impairment group（all P〈 0.05）. Logistic multiple regression analysis showed that age, marital status, T2DM history, cerebrovascular disease history and comorbidities were positively correlated with cognitive impairment（all P〈0.05）. Education was negatively correlated with cognitive impairment（P〈0.05）. Conclusions Cognitive impairment is associated with age,education,marital status,T2DM history,cerebrovascular disease history and comorbidities.

关 键 词：认知障碍 危险因素 

分 类 号：R749.1[医药卫生—神经病学与精神病学]