中老年高血压人群H型高血压患病程度与认知功能关系分析  

H-type Hypertension Severity and Cognitive Function in Middle-aged and Elderly Chinese People with Hypertension

作　　者：魏心源 蒋与刚 黄承钰[3] 杨璐芮 宋玉庆 程道梅 WEI Xinyuan;JIANG Yugang;HUANG Chengyu;YANG Lurui;SONG Yuqing;CHENG Daomei(Department of Public Health,Chengdu Medical College,Chengdu 610500,China;Institute of Environmental and Operational Medicine,Military Medical Research Institute of Military Academy,Tianjin 300050,China;West China School of Public Health,Sichuan University,Chengdu 610041,China;The PLA 32296 Troops,Shenyang 110112,China)

机构地区：[1]成都医学院公共卫生学院,四川省成都市610500 [2]军事科学院军事医学研究院环境医学与作业医学研究所,天津市300050 [3]四川大学华西公共卫生学院,四川省成都市610041 [4]中国人民解放军32296部队,辽宁省沈阳市110112

出　　处：《中国全科医学》2021年第20期2520-2526,共7页Chinese General Practice

基　　金：四川省教育厅自然科学重点项目(18ZA0166)——社区老年人群H型高血压与轻度认知功能障碍的横断面调查及关系分析。

摘　　要：背景H型高血压是指伴有高同型半胱氨酸血症的高血压,我国高血压患者众多,其中H型高血压约占75%,且发病率处于上升趋势。高血压、高同型半胱氨酸血症均为认知功能损伤的危险因素,H型高血压对患者认知功能可能造成更大损害,对患者生活质量产生更为严重的不良影响。目的调查中老年高血压患者中H型高血压现况,分析H型高血压患病程度与认知功能的关系,为相关防控提供依据。方法2020年3—11月,选取2007年3月—2008年11月居住在天津市5个社区(安乐村社区、咸阳路社区、龙兴里社区、尚友里社区、荣迁东里社区)及2个养老机构(天津市养老院、天津市和平区老年公寓)的97例高血压患者为研究对象。采用面对面访谈的方法收集研究对象的人口学特征:性别、年龄、受教育年限、婚姻状况、居住情况、月收入;生活方式:饮酒、吸烟、喝咖啡、饮茶以及每日饮水量、每日睡眠时间、每日锻炼时间;维生素服用情况。使用简易精神状态量表(MMSE)初步评估研究对象的认知状态,MMSE得分<26分作为轻度认知障碍(MCI)的判定标准。采用基本认知能力测验(BCAT)评估研究对象的认知功能。根据血清总同型半胱氨酸(tHcy)水平进行分组:tHcy<10μmol/L为单纯性高血压组,10μmol/L≤tHcy≤15μmol/L为轻度H型高血压组,15μmol/L<tHcy≤30μmol/L为中度H型高血压组,tHcy>30μmol/L为重度H型高血压组。采用多重线性回归分析探讨H型高血压与认知功能的关系。结果共检出H型高血压84例,检出率为86.60%。97例研究对象中单纯性高血压组13例(13.40%),轻度H型高血压组31例(31.96%),中度H型高血压组53例(54.64%)。中度H型高血压组居住情况与单纯性高血压组、轻度H型高血压组比较,差异有统计学意义(P<0.05)。共检出MCI患者17例(17.53%),其中单纯性高血压组检出MCI患者4例(30.77%),轻度H型高血压组检出4例(12.90%),中度H型Background H-type hypertension refers to hypertension accompanied by hyperhomocysteinemia(HHcy).It accounts for about 75%of all the types of hypertension and is increasing in the large number of Chinese hypertension patients.Hypertension and HHcy are both risk factors for cognitive impairment.H-type hypertension may have more serious adverse effects on cognitive function and quality of life of patients.Objective To investigate the prevalence of H-type hypertension,and the association of its severity with cognitive function in middle-aged and elderly hypertensive patients,providing evidence for related disease prevention and control.Methods From March to November 2020,a total of 97 patients with hypertension who lived in 5 communities(Anle Village,Xianyang Road,Longxingli,Shangyouli,Rongqiandongli)and 2 nursing homes(Tianjin Nursing Home and Heping District Apartment for the Elderly)in Tianjin were selected from March 2007 to November 2008.A face-to-face interview was conducted to collect demographic characteristics,including gender,age,years of education,marital status,residence status,monthly income,lifestyle(drinking,smoking,coffee consumption,tea consumption,daily water intake,daily sleep time,daily exercise time,and vitamin intake).The Mini-Mental State Examination(MMSE)was used to initially assess the cognitive function,by using MMSE score<26 as a criterion for mild cognitive impairment(MCI).The Basic Cognitive Aptitude Test(BCAT)was used for further evaluating the cognitive function.The patients were divided into three groups according to the level of serum total homocysteine(tHcy):tHcy<10μmol/L,10μmol/L≤tHcy≤15μmol/L,15μmol/L<tHcy≤30μmol/L and tHcy>30μmol/L were considered as simple hypertension,mild,and moderate H-type hypertension,respectively.Multiple linear regression was used to analyse the relationship between H-type hypertension and cognitive function.Results The prevalence of H-type hypertension was 86.60%(84/97).Among the 97 subjects,13(13.40%)were found with simple hypertension,31(31.

关 键 词：高血压 H型高血压 中年人 老年人 发病率 认知功能障碍 

分 类 号：R544.1[医药卫生—心血管疾病]