慢性阻塞性肺疾病住院患者认知功能特点及影响因素研究  

The features of cognitive function in inpatients with chronic obstructive pulmonary disease and the influencing factors

作　　者：苏玉梅[1] SU Yu-mei(Department of Respiratory and Critical Care Medicine,Guangyuan Central Hospital,Guangyuan 628000,China)

机构地区：[1]四川省广元市中心医院呼吸与危重症医学科,四川广元628000

出　　处：《实用医院临床杂志》2020年第5期76-79,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)住院患者认知功能特点,并分析其影响因素。方法我院收治的86例COPD住院患者,以蒙特利尔认知评估量表(MOCA)评估其认知功能,比较不同特征患者MOCA评分,并分析其影响因素。结果86例患者中,52例(60.47%)认知受损,34例(39.53%)认知功能正常;年龄≥65岁、吸烟指数≥600、小学与初中、病程≥11年、家庭人均收入≤2000元/月、不了解疾病、呼吸困难4级、COPD III^IV级、PaO2<60 mmHg、PaCO2≥50 mmHg、SAS评分>50分、SDS评分>50分患者MOCA评分明显低于<65岁、吸烟指数<600、高中及以上、病程≤10年、家庭人均收入>2000元/月、对疾病有一定了解、呼吸困难0~3级、COPD I^II级、PaO2≥60 mmHg、PaCO2<50 mmHg、SAS评分≤50分、SDS评分≤50分患者(P<0.05);年龄≥65岁、受教育程度小学及初中、呼吸困难4级、COPD III^IV级、PaO2<60 mmHg、SDS评分>50分为COPD住院患者认知功能损伤独立危险因素(P<0.05)。结论COPD住院患者存在一定程度认知功能损伤,临床应依据患者年龄、受教育程度、呼吸困难分级、COPD严重程度、PaO2及SDS评分等因素,给予针对性干预措施,以改善其认知受损情况。Objective To observe the features of cognitive function in inpatients with chronic obstructive pulmonary disease(COPD),and to analyze the influencing factors.Methods Eighty-six inpatients with COPD were enrolled in the study.The cognitive function was assessed by Montreal cognitive assessment(MOCA).MOCA scores among patients with different features were compared and logistic regression analysis was performed to conduct multivariate analysis.Results Of the 86 patients,there were 52 cases(60.47%)with cognitive damage,and 34 cases(39.53%)with normal cognitive function.MOCA scores in patients with age older than 65 years old,smoking index larger than 600,primary and junior high school education level,course of disease longer than 11 years,family per capita income not more than 2000 yuan/month,no understanding about disease,dyspnea at level 4,COPD at grade III to IV,PaO2less than60 mmHg,PaCO2not less than 50 mmHg,SAS score greater than 50 points and SDS score greater than 50 points were significantly lower than those with age younger than 65 years old,smoking index less than 600,senior high school and above education level,course of disease not longer than 10 years,family per capita income more than 2000 yuan/month,understanding disease,dyspnea at level 0~3,COPD at grade I to II,PaO2not less than60 mmHg,PaCO2less than 50 mmHg,SAS score not greater than 50 points and SDS score not greater than 50 points.Logistic regression analysis showed that age older than 65 years,primary and junior high school education level,dyspnea at level 4,COPD at grade III to IV,PaO2less than60 mmHg,and SDS score greater than 50 points were independent risk factors for cognitive impairment in COPD inpatients(P<0.05).Conclusion There is cognitive function impairment in COPD inpatients.Clinically,targeted interventions should be given according to age,education level,dyspnea grade,COPD severity,PaO2and SDS scores to improve their cognitive impairment.

关 键 词：慢性阻塞性肺疾病 认知功能 影响因素 

分 类 号：R563[医药卫生—呼吸系统]