中青年高血压住院患者轻度认知功能障碍发生现状及影响因素研究  

Prevalence and Associated Factors of Mild Cognitive Impairment in Young and Middle-aged Hospitalized Patients with Hypertension

作　　者：叶青芳[1,2] 王旖旎[3] 李玲[3] 刘国杰[3] 林平[3] 李秋洁[1] YE Qingfang;WANG Yini;LI Ling;LIU Guojie;LIN Ping;LI Qiujie(School of Nursing,the Second Affiliated Hospital of Harbin Medical University,Harbin 150000,China;Department of Basic Nursing,School of Nursing,Harbin Medical University,Daqing 163319,China;Department of Cardiology,the Second Affiliated Hospital of Harbin Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第二医院护理学院,黑龙江省哈尔滨市150000 [2]哈尔滨医科大学护理学院基础护理学部,黑龙江省大庆市163319 [3]哈尔滨医科大学附属第二医院心内科,黑龙江省哈尔滨市150000

出　　处：《中国全科医学》2023年第2期154-159,167,共7页Chinese General Practice

基　　金：国家自然科学基金资助项目(72004045);黑龙江省省属高等学校基本科研业务费基础研究项目(JFYQPY202103);2020年哈尔滨医科大学“课程思政”专项课题(SZQ202020)。

摘　　要：背景高血压患者轻度认知功能障碍(MCI)的发生率较高,但目前国内外针对高血压患者MCI的研究多集中在老年群体,缺少中青年高血压患者MCI的发生情况及相关影响因素研究。目的探讨中青年高血压住院患者MCI发生现状,并分析其影响因素。方法采用便利抽样法,选取2021年5—12月在哈尔滨市某三级甲等医院住院的中青年高血压患者,采用一般资料调查表、蒙特利尔认知评估量表、D型人格量表进行调查,采用多因素Logistic回归分析中青年高血压住院患者MCI的影响因素。结果共纳入213例中青年高血压住院患者,MCI的发生率为37.56%(80例)。多因素Logistic回归分析结果显示年龄〔OR=1.073,95%CI(1.033,1.115)〕、受教育程度〔大专:OR=0.278,95%CI(0.084,0.920)〕、吸烟史〔OR=2.494,95%CI(1.146,5.426)〕、高血压分级〔2级:OR=3.442,95%CI(1.252,9.468);3级:OR=3.934,95%CI(1.518,10.193)〕、D型人格〔OR=2.160,95%CI(1.015,4.598)〕、三酰甘油(TG)〔OR=1.596,95%CI(1.125,2.265)〕、高密度脂蛋白胆固醇(HDL-C)〔OR=0.185,95%CI(0.049,0.707)〕是中青年高血压住院患者MCI的影响因素(P<0.05)。结论中青年高血压住院患者MCI发生率较高,高龄、低教育水平、D型人格、高TG及低HDL-C的高血压患者更容易发生MCI。医护人员应当尽早对中青年高血压患者进行MCI的评估与危险因素筛查,以发现MCI的高危人群并进行有效防控。Background Mild cognitive impairment(MCI)is highly prevalent in hypertensive patients,but the current studies on MCI in hypertension mostly focus on the elderly group,while scarcely involve young and middle-aged patients.Objective To investigate the prevalence and associated factors of MCI in young and middle-aged hospitalized patients with hypertension.Methods A convenience sample of 213 young and middle-aged hypertensive inpatients were recruited from a tertiary grade A hospital in Harbin from May to December 2021.The General Demographic Questionnaire,Montreal Cognitive Assessment(MoCA),and the Type-D Scale-14(DS14)were used for understanding patients'demographics,cognitive impairment status,and D-type personality prevalence,respectively.Multiple Logistic regression was used to analyze associated factors of MCI.Results The prevalence of MCI was 37.56%(80/213).Multiple Logistic regression analysis showed that age〔OR=1.073,95%CI(1.033,1.115)〕,education level〔junior college education level:OR=0.278,95%CI(0.084,0.920),smoking history〔OR=2.494,95%CI(1.146,5.426)〕,stage of hypertension〔stage 2:OR=3.442,95%CI(1.252,9.468);stage 3:OR=3.934,95%CI(1.518,10.193)〕,D-type personality〔OR=2.160,95%CI(1.015,4.598),TG〔OR=1.596,95%CI(1.125,2.265)〕,and HDL-C〔OR=0.185,95%CI(0.049,0.707)〕were influential factors of MCI in hypertension(P<0.05).Conclusion Young and middle-aged hospitalized patients with hypertension had a high prevalence of MCI.Older age,lower level of education,D-type personality,higher level of TG and lower level of HDL-C were related to increased risk of MCI in hypertension.In view of this,medical workers should screen MCI in these patients to identify those at high risk of MCI as early as possible,and deliver interventions to them timely.

关 键 词：高血压 认知功能障碍 中年人 青年人 D型人格 影响因素分析 

分 类 号：R544.1[医药卫生—心血管疾病]