6MWD与慢性阻塞性肺疾病患者认知功能受损相关性研究  

Correlation between 6MWD and cognitive impairment in COPD:a retrospective study

作　　者：何胜东 杨树栋[2] 文礼[3] 黄志健[2] He Shengdong;Yang Shudong;Wen Li;Huang Zhijian(Department of Pulmonary Medicine,Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou 646000,China;Department of Cardiopulmonary Disease(Xianhu),the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China;Department of Pulmonary Medicine(Dongge),the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China)

机构地区：[1]西南医科大学附属中医医院肺病科,泸州646000 [2]广西中医药大学第一附属医院仙葫院区心肺病科,南宁530023 [3]广西中医药大学第一附属医院东葛院区肺病科,南宁530023

出　　处：《国际呼吸杂志》2020年第23期1791-1795,共5页International Journal of Respiration

基　　金：四川省教育厅重点项目(16ZA0191);西南医科大学科研项目(16022)。

摘　　要：目的:了解稳定期慢性阻塞性肺疾病(COPD)患者认知能力水平,明确6分钟步行距离(6MWD)是否与COPD认知功能受损有关。方法:选取2017年9月至2019年6月广西中医药大学第一附属医院门诊128例完成蒙特利尔认知评估量表(MoCA)和6分钟步行试验的稳定期COPD患者相关临床资料进行回顾性研究,采用SPSS 22.0软件进行t检验、χ2检验和二元Logistic回归分析。结果:COPD患者的认知功能总分范围为19~30分,平均(25.1±3.1)分,其中72例(56.3%)COPD患者具有认知功能受损;认知功能受损的COPD患者6MWD[(274.2±70.2)m]显著短于无认知功能受损的COPD患者[(368.6±71.4)m](t=7.482,P<0.01);认知功能受损的COPD患者运动性低氧血症发生率显著高于无认知功能受损的COPD患者(χ2=18.171,P<0.01);6MWD是COPD患者认知功能损害的独立危险因素(OR=1.025,P<0.01)。结论:6MWD是COPD患者认知受损的独立危险因素,提高运动耐力可能是预防和改善COPD患者认知功能受损的重要干预手段。Objective:To ascertain the correlation between the six minute walk test distance(6MWD)and cognitive impairment in patients with chronic obstructive pulmonary disease(COPD).Methods:The study retrospectively analyzed the detailed clinical data of 128 outpatients with stable COPD in the First Affiliated Hospital of Guangxi University of Chinese Medicine from September 2017 to June 2019,who completed the Montreal Cognitive Assessment(MoCA)and Six Minute Walking Test.All data were analyzed using the SPSS 18.0 software.Results:MoCA scores ranged from 19 to 30 in COPD patients.The average score for all patients was 25.1±3.1.The prevalence of cognitive impairment in COPD patients was 56.3%.Compared to patients with normal recognition,the 6MWD of patients with cognitive impairment was significantly shorter[(274.2±70.2)m vs(368.6±71.4)m,t=7.482,P<0.01].The incident rate of exercise-induced hypoxemia was higher in cognitively impaired patients than in patients with normal cognitive function(χ2=18.171,P<0.01).Besides education and exacerbation frequency,6MWD was an independent risk factor for cognitive impairment in patients with COPD(OR=1.025,P<0.01).Conclusions:COPD patients with cognitive impairment have a decrease in 6MWD,and 6MWD is an independent risk factor for cognitive impairment in COPD.

关 键 词：肺疾病 慢性阻塞性 危险因素 6分钟步行试验 认知功能 蒙特利尔认知评估量表 

分 类 号：R563.9[医药卫生—呼吸系统]