70岁及以上人群收缩压与认知障碍的相关关系:一项以西安市鄠邑区农村人群为基础的横断面调查  

Correlation between systolic blood pressure and cognitive impairment in people aged 70 years and above:A cross-sectional survey based in a rural area of Xi'an,China

作　　者：商苏杭 马楼艳 张彬艳 王瑾[1] 霍康[1] 曹红梅[1] 米白冰 江毓 陈晨[1] 党亮君 高玲 魏珊 杨剑波[1] 屈秋民[1] SHANG Suhang;MA Louyan;ZHANG Binyan;WANG Jin;HUO Kang;CAO Hongmei;MI Baibing;JIANG Yu;CHEN Chen;DANG Liangjun;GAO Ling;WEI Shan;YANG Jianbo;QU Qiumin(Department of Neurology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Department of Geriatrics,the Ninth Hospital of Xi'an,Xi'an 710054;Department of Epidemiology and Biostatistics,School of Public Health of Xi'an Jiaotong University Health Science Center,Xi'an 710061;Department of Neurology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第一附属医院神经内科,陕西西安710061 [2]西安市第九医院老年病科,陕西西安710054 [3]西安交通大学医学部公共卫生学院流行病与卫生统计系,陕西西安710061 [4]西安交通大学第二附属医院神经内科,陕西西安710004

出　　处：《西安交通大学学报（医学版）》2020年第6期956-960,965,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家卫健委社区脑卒中高危人群筛查资助项目;陕西省社会发展科技攻关资助项目(No.2016SF-053)。

摘　　要：目的分析70岁及以上人群血压与认知障碍的相关关系。方法选取2014年10月—2015年3月西安市鄠邑区某村≥70岁全部常住村民作为研究对象,测定坐位血压。应用简易精神状态量表(MMSE)评估认知功能,以MMSE评分低于分界值作为认知障碍的判断标准,即文盲≤17分,小学文化程度≤20分,中学及以上文化程度≤24分。采用多因素Logistics回归校正混杂因素。结果全村共有≥70岁常住村民236人,实际完成血压测量及MMSE测查者217人(占92.0%),排除既往卒中患者后纳入186人,其中男性87人(46.8%),年龄70~85岁,平均(74.17±3.97)岁,符合认知障碍者64人(34.4%)。收缩压(SBP)为(143.45±20.25)mmHg(1 mmHg=0.133 kPa),≤139 mmHg者(较低SBP组)69人,140~159 mmHg者(参照组)66人,≥160 mmHg者(较高SBP组)51人。单因素分析显示,较低SBP组(40.6%)、较高SBP组(37.3%)认知障碍患病率均高于参照组(25.8%,P=0.171);多因素Logistics回归分析显示,与参照组相比,较低SBP组(OR=2.99,95%CI 1.19~7.53,P=0.020)或较高SBP组(OR=2.66,95%CI 0.97~7.28,P=0.057)认知障碍患病风险升高。舒张压(DBP)为(82.48±10.34)mmHg,≤89 mmHg者136人(73.1%),90~99 mmHg者29人(15.6%),≥100 mmHg者21人(11.3%),3组间认知障碍患病率无显著差异(35.3%vs.34.5%vs.28.6%,P=0.833)。多因素Logistics回归分析显示,3个DBP组间认知障碍患病风险无显著差异(P=0.714)。结论在≥70岁人群横断面调查中,SBP低于140 mmHg或者高于160 mmHg均与基于MMSE判定的认知障碍患病风险升高相关。DBP与认知障碍之间未发现显著相关性。Objective To study the relationship between blood pressure and cognitive impairment in people aged≥70 years.Methods From October 2014 to March 2015,blood pressure and global cognitive function information were collected from the participants aged≥70 years who lived in a village in the suburbs of Xi'an,China,during in-person interviews.Mini-mental State Examination(MMSE)was used to evaluate global cognitive function.Cognitive impairment was defined as the MMSE score lower than the cutoff value.Specifically,the cutoff value was≤17 for the illiterate,≤20 for the primary school educated,and≤24 for those educated at the junior high school level and above.Multivariate Logistic regression was performed to correct confounding factors.Results A total of 236 permanent residents aged≥70 lived in the village.Of them 217 subjects(92.0%)completed blood pressure measurement and MMSE examination and 31 subjects were excluded because of previous stroke.A total 186 subjects were enrolled in the analysis,including 87 males(46.8%).The age ranged from 70 to 85 years(mean 74.17±3.97 years),and 64 people(34.4%)were diagnosed with cognitive impairment.The mean systolic blood pressure(SBP)was(143.45±20.25)mmHg.Totally 69 subjects had SBP of≤139 mmHg,66 subjects had SBP of 140-159 mmHg,and 51 subjects had SBP of≥160 mmHg.Univariate analysis showed that both subjects with SBP≤139 mmHg and those with SBP≥160 mmHg had a higher prevalence of cognitive impairment compared with the subjects with SBP of 140-159 mmHg(≤139 mmHg vs.140-159 mmHg vs.≥160 mmHg,40.6%vs.25.8%vs.37.3%,P=0.171).Multivariate Logistic regression analysis showed that compared with the reference group(140-159 mmHg),both subjects with a lower SBP(OR=2.99,95%CI 1.19-7.53,P=0.020)and those with a higher SBP(OR=2.66,95%CI 0.97-7.28,P=0.057)had a higher risk of cognitive impairment.The mean diastolic blood pressure(DBP)was(82.48±10.34)mmHg.136(73.1%)subjects had DBP of≤89 mmHg,29(15.6%)subjects had DBP of 90-99 mmHg,and 21(11.3%)ones had DBP of≥100 m

关 键 词：老年人群 血压 认知障碍 横断面调查 

分 类 号：R54[医药卫生—心血管疾病]