血压变异性与帕金森病患者认知功能的关系  

The relationship between blood pressure variability and cognitive function in patients with Parkinson's disease

作　　者：李丽霞[1] 连滕宏 左丽君[2] 郭鹏[2] 扈杨 丁杜宇 李丹凝 刘丽[1] 赵慧[1] 张巍[3,4,5,6] LI Lixia;LIAN Tenghong;ZUO Lijun;GUO Peng;HU Yang;DING Duyu;LI Dangning;LIU Li;ZHAO Hui;ZHANG Wei(不详;Center for Cognitive Neurology,Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院综合内科,100070 [2]首都医科大学附属北京天坛医院神经病学中心,100070 [3]首都医科大学附属北京天坛医院神经病学中心认知障碍科,100070 [4]国家神经系统疾病临床医学研究中心,100070 [5]教育部神经变性疾病重点实验室,100069 [6]北京脑重大疾病研究院帕金森病研究所,100053

出　　处：《中国神经免疫学和神经病学杂志》2020年第6期448-452,共5页Chinese Journal of Neuroimmunology and Neurology

基　　金：国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项(2016YFC1306000,2016YFC1306300);国家重点研发计划-欧盟地平线2020计划合作项目(2017YFE0118800-779238);国家自然科学基金面上项目(81970992,81571229,81071015,30770745);北京市教育委员会科技发展计划重点项目(KZ201610025030);北京市自然科学基金重点项目(4161004)。

摘　　要：目的探讨血压变异性对帕金森病(Parkinson disease,PD)患者认知功能的可能影响。方法连续收集北京天坛医院住院的PD患者165例,记录人口学资料及临床特征,采用蒙特利尔认知评估量表(MoCA)评价认知功能。根据MoCA评分,将上述患者分为PD不伴认知障碍(PD-NCI)组(≥26分)、PD伴发轻度认知障碍(PD-MCI)组(26分>MoCA评分≥14分)及PD伴发痴呆(PDD)组(<14分)。记录所有患者24小时动态血压监测结果,获得24小时血压及血压变异性参数(标准差),进行三组间比较,并对PD患者MoCA评分与全天平均血压及血压标准差进行相关性分析。结果(1)PD-MCI组及PDD组的年龄明显大于PD-NCI组(P<0.05)。PDD组H-Y分期明显高于PD-MCI组及PD-NCI组(P<0.05)。(2)与PD-NCI组比较,PD-MCI组全天平均收缩压〔111.00(105.75~119.25)mmHg比116.00(112.00~122.00)mmHg〕和平均舒张压〔70.0(64.00~74.00)mmHg比74.00(69.00~81.00)mmHg〕明显升高(P<0.05),全天收缩压标准差[11.25(8.90~13.40)mmHg比12.70(11.10~15.20)mmHg]明显增大(P<0.05);PDD组全天平均收缩压〔111.00(105.75~119.25)mmHg比126.50(117.50~137.50)mmHg〕和平均舒张压〔70.0(64.00~74.00)mmHg比76.00(71.25~83.25)mmHg〕明显升高(P<0.05),全天收缩压标准差〔11.25(8.90~13.40)mmHg比13.85(12.40~15.73)mmHg〕和舒张压标准差〔8.30(7.58~9.80)mmHg比10.50(9.10~10.88)mmHg〕明显增大(P<0.05)。与PD-MCI组比较,PDD组患者全天平均收缩压水平〔116.00(112.00~122.00)mmHg比126.50(117.50~137.50)mmHg〕明显升高(P<0.05)。(3)MoCA评分与全天收缩压标准差呈明显负相关(r=-0.290,P<0.05);与全天平均收缩压、全天平均舒张压及全天舒张压标准差无明显相关性。结论PD患者认知障碍程度越重,血压变异性可能更大。MoCA评分与全天收缩压标准差呈负相关。Objective To investigate the effect of blood pressure variability on cognitive function in patients with Parkinson's disease(PD).Methods The data of 165 patients with Parkinson's disease,who were admitted to Beijing Tiantan Hospital,was consecutively collected.The demographic data andclinical features were recorded.These patients were divided into a PD without cognitive impairment(PD-NCI)group,a PD with mildcognitive impairment(PD-MCI)group and a PD with dementia(PDD)group based on the evaluation of cognitive function using the Montreal Cognitive Assessment Scale.The 24-hour blood pressure parameters of blood pressure variability(standard deviation of blood pressure)was collected from the 24-hour ambulatory blood pressure monitoring of the enrolled patients.Results(1)The age of PD-MCI group and PDD group was significantly higher than that of PD-NCI group(P<0.05).The H-Y stage of PDD group was significantly higher than that of PD-MCI group and PD-NCI group(P<0.05).(2)Compared with the PD-NCI group,the mean systolic blood pressure[111.00(105.75~119.25)mmHg vs.116.00(112.00~122.00)mmHg]and the mean diastolic blood pressure[70.0(64.00~74.00)mmHg vs.74.00(69.00~81.00)mmHg]and the standard deviation of systolic blood pressure throughout the day[11.25(8.90~13.40)mmHg vs.12.70(11.10~15.20)mmHg]were significantly increased in the PD-MCI group(P<0.05);the mean systolic blood pressure[111.00(105.75~119.25)mmHg vs.126.50(117.50~137.50)mmHg]and the mean diastolic blood pressure[70.0(64.00~74.00)mmHg vs.76.00(71.25~83.25)mmHg]were significantly increased in the PDD group(P<0.05);the standard deviation of systolic blood pressure[11.25(8.90~13.40)mmHg vs.12.70(11.10~15.20)mmHg]and the standard deviation of diastolic blood pressure[8.30(7.58~9.80)mmHg vs.10.50(9.10~10.88)mmHg]were increased in the PDD group(P<0.05).Compared with the PD-MCI group,the average daily systolic blood pressure level[116.00(112.00~122.00)mmHg vs.126.50(117.50~137.50)mmHg]was increased in the PDD group(P<0.05).(3)A negative correlation was found between t

关 键 词：帕金森病 血压变异性 认知功能 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R473.74[医药卫生—临床医学]