伴有认知功能障碍的慢性心力衰竭患者认知功能的影响因素及预后分析  

Analysis on influencing factors and prognosis of cognitive function in patients with chronic heart failure complicating with cognitive impairment

作　　者：施倩茹 冯红选[1] 侯晓夏 王媚瑕 徐波 桂千 吴冠会[1] 朱伟 沈明强[1] 赵慧敏 郭兴 程庆璋[1] SHI Qianru;FENG Hongxuan;HOU Xiaoxia;WANG Meixia;XU Bo;GUI Qian;WU Guanhui;ZHU Wei;SHEN Mingqiang;ZHAO Huimin;GUO Xing;CHENG Qingzhang(Department of Neurology,Gusu College of Nanjing Medical University/Affiliated Suzhou Hospital of Nanjing Medical University/Suzhou Municipal Hospital,Suzhou,Jiangsu 215000,China;College of Basic Medicine,Nanjing Medical University,Nanjing,Jiangsu 211166,China)

机构地区：[1]南京医科大学姑苏学院/南京医科大学附属苏州医院/苏州市立医院神经内科,江苏苏州215000 [2]南京医科大学基础医学院,211166

出　　处：《重庆医学》2022年第22期3915-3919,共5页Chongqing medicine

基　　金：南京医科大学姑苏学院姑苏课题(GSKY20210207);江苏省苏州市科教兴卫青年项目(KJXW2021035)。

摘　　要：目的了解伴有认知功能障碍(CI)的慢性心力衰竭(CHF)患者的认知功能情况,探讨其影响因素及预后。方法从南京医科大学附属苏州医院门诊及住院的200例CHF患者中选取符合条件的132例患者,根据蒙特利尔认知功能评估表(MOCA)对其认知功能进行评分,分为CI组和认知正常组,分析伴CI的CHF患者认知功能的影响因素及心功能改善后患者的认知改善情况。结果CI组认知功能评分明显低于认知正常组,差异有统计学意义(P<0.05)。经济水平、文化程度、心功能分级、心房颤动、左心室射血分数(LVEF)、贫血、生活质量评分对伴CI的CHF患者认知功能具有显著影响。经规范改善心功能治疗3个月后,CI组患者认知功能总体较前改善,LVEF下降组的患者认知功能评分低于LVEF保留组,且经治疗后LVEF保留组认知功能改善程度高于LVEF下降组。结论CHF患者发生CI概率较高,早期评估伴CI的CHF患者认知功能的影响因素并尽早采取治疗措施对其认知功能的提升有一定帮助,进而改善预后。Objective To understand the cognitive function situation in the patients with chronic heart failure(CHF)complicating with cognitive impairment(CI),and to explore its influencing factors and prognosis.Methods A total of 132 eligible cases selected from 200 outpatients and inpatients with CHF treated in Affiliated Suzhou Hospital of Nanjing Medical University.The cognitive function on these patients was evaluated according to the Montreal Cognitive Function Assessment(MOCA)scale.These cases were divided into the CI group and the cognition normal group.The influencing factors of cognitive function in the patients with CHF complicating with CI and their cognitive was improved situation after cardiac function improvement were analyzed.Results The cognitive function score in the CI group was significantly lower than that in the cognition normal group,and the difference was statistically significant(P<0.05).The economic level,cultural level,cardiac function grade,atrial fibrillation,left ventricular ejection fraction(LVEF),anemia and quality of life score had significant influence on the cognitive function of the patients with CHF complicating with CI.After 3-month standardized cardiac function improvement treatment,the cognitive function of the patients in the CI group was generally improved when compared with before treatment,the cognitive function score of the LVEF decrease group was lower than that of the LVEF reservation group,moreover the cognitive function improvement level after treatment in the LVEF reservation group was higher than that in the LVEF decrease group after treatment.Conclusion The patients with CHF have a higher probability of CI occurrence.Early assess the influencing factors of cognitive function in the patients with CHF complicating with CI and adopt the treatment measures as early as possible have a certain help to increase their cognitive function,thus improve their prognosis.

关 键 词：认知功能障碍 慢性心力衰竭 影响因素 认知 预后 

分 类 号：R741[医药卫生—神经病学与精神病学]