认知功能障碍与射血分数降低型心力衰竭患者不良预后的相关性分析  

Analysis of cognitive impairment associated with poor prognosis in patients with heart failure with reduced ejection fraction

作　　者：周莹[1] 王琴[1] ZHOU Ying;WANG Qin(Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院心内科,江苏南京210029

出　　处：《医药前沿》2022年第25期28-31,35,共5页Journal of Frontiers of Medicine

摘　　要：目的:探讨认知功能障碍对射血分数降低型心力衰竭(HFrEF)患者预后的影响。方法:选择2018年5月—2019年2月南京医科大学第一附属医院心内科收治的HFrEF患者114例。采用蒙特利尔认知评估量表(MoCA)对患者进行认知功能评估;使用Kaplan-Meier法绘制生存曲线,采用单因素及多因素COX回归分析认知功能障碍与HFrEF患者全因死亡和心衰恶化再入院的关系。结果:114例患者,其中44例(38.6%)认知功能正常,70例(61.4%)伴有认知功能障碍。中位随访21个月,Kaplan-Meier生存曲线发现,伴有认知障碍的患者全因死亡和心衰恶化再入院率明显高于认知功能正常的患者(LogrankP=0.013)。多因素Cox回归提示,认知功能障碍是HFrEF患者全因死亡和心衰恶化再入院的独立危险因子(HR=2.09,95%CI:1.06~4.14,P=0.033)。结论:HFrEF患者常合并认知功能障碍,认知功能障碍是HFrEF患者不良预后的独立危险因素。Objective To evaluate the cognitive function by Montreal Cognitive Assessment(MoCA)and its prognostic value in patients with heart failure with reduced ejection fraction(HFrEF).Methods The patients admitted to our department for HFrEF from May 2018 to February 2019.The Montreal Cognitive Assessment was carried out to assess cognitive function of the patients.A total score of MoCA below 26 points was regarded as cognitive impairment.Kaplan-Meier analysis,univariate and multivariate regression analysis were performed to assess the association between cognitive function and all-cause death and rehospitalization for heart failure in these patients.Results Among 114 patients,a total of 44(38.6%)patients had normal cognitive function while 70(61.4%)patients were screened positive for cognitive impairment.After a median follow-up of 21 months,Kaplan-Meier curve demonstrated that the all-cause mortality and rehospitalization for heart failure was significantly higher in patients with cognitive impairment(Logrank P=0.013).Multivariate Cox regression revealed that cognitive impairment was an independent risk of all-cause death and rehospitalization for heart failure in patients with HFrEF(hazard ratio[HR]=2.09,95%confidence intervention[CI]:1.06~4.14,P=0.033).Conclusion Cognitive impairment is a common condition and is associated with poor prognosis in patients with HFrEF.

关 键 词：射血分数降低型心力衰竭 MOCA量表 认知功能障碍 预后 

分 类 号：R541.6[医药卫生—心血管疾病]