高龄老人体位性低血压对轻度认知功能障碍的影响  

Effect of orthostatic hypotension on mild cognitive impairment in elderly

作　　者：刘晶晶[1] 李楠楠[1] LIU Jing-jing;LI Nan-nan(Department of Geriatrics Cardiology,First Hospital of China Medieal University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院老年心血管内科,辽宁沈阳110001

出　　处：《中国实用内科杂志》2021年第4期315-320,共6页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金青年基金(81302190)。

摘　　要：目的探讨高龄老人体位性低血压对轻度认知功能障碍的影响。方法选取中国医科大学附属第一医院2018年6月至2020年6月收治的110例高龄住院患者为研究对象,年龄80~98岁(87.30±4.24)岁,根据体位性低血压(orthostatic hypotension,OH)诊断标准将患者分为体位性低血压组(OH组)和非体位性低血压组(non-orthostatic hypotension,NOH)组,2组均采用蒙特利尔认知量表(montreal cognitive assessment,MoCA)评价患者的认知功能,并收集一般临床资料及血液生化指标。结果OH组52例(47.27%),NOH组58例(52.73%),OH组MoCA得分(23.96±2.26)低于NOH组(25.55±2.23)(P<0.001),另外,与NOH组对比,OH组的年龄、共患慢性疾病种类和高血压的患病率明显增高(均P<0.05),而BMI、估计的肾小球滤过率明显减低(均P<0.05)。多因素Logistic回归分析显示:OH、BMI以及血清同型半胱氨酸水平与认知功能障碍独立相关[OR(95%CI)分别为2.708(1.027~7.143),0.687(0.527~0.897),1.103(1.012~1.202),P值均<0.05]。结论OH、低BMI水平以及高同型半胱氨酸血症是高龄老人发生轻度认知障碍的独立危险因素。Objective To explore the effect of orthostatic hypotension on mild cognitive function in elderly patients.Methods A total of 110 elderly inpatients,aged 80-98(87.30±4.24)years old,were selected in the first hospital of China medical univercity from June 2018 to June 2020.According to the diagnostic criteria for orthostatic hypotension(OH),the patients were divided into the OH group and the Non-Orthostatic Hypotension(NOH)group.The cognitive function of all subjects was assessed with the Montreal Cognitive Assessment(MoCA).General clinical data and hematological variables were collected).Results 52 patients(47.27%)were admitted to the OH group,58 patients(52.73%)were admitted to the NOH group,and the MoCA score in the OH group(23.96±2.26)was lower than that in the NOH group(25.55±2.23)(P<0.001).In addition,compared with the NOH group,the age,types of chronic diseases and prevalence of hypertension in the OH group were significantly increased(all P<0.05),while BMI and estimated glomerular filtrationrate in the OH group were significantly decreased(all P<0.05).Multivariate logistic regression analysis showed that OH,BMI and serum homocysteine level were independently associated with cognitive impairment[OR(95%CI)were 2.708(1.027-7.143),0.687(0.527-0.897),1.103(1.012-1.202)respectively,P<0.05].Conclusion OH,low BMI and Hyperhomocysteinemia are independent risk factors for mild cognitive impairment in the elderly.

关 键 词：高龄 体位性低血压 认知功能 危险因素 痴呆 

分 类 号：R544.2[医药卫生—心血管疾病]