老年抑郁症人群认知功能损害与微血管功能障碍的关系  

Relationship between cognitive impairment and microvascular dysfunction in elderly depression population

作　　者：张晓娟 邓祥瑞 陈睿 钟文[1] ZHANG Xiaojuan;DENG Xiangrui;CHEN Rui;ZHONG Wen(The Third People’s Hospital of Chengdu,Chengdu 610000,China)

机构地区：[1]成都市第三人民医院,四川成都610000

出　　处：《中国实用神经疾病杂志》2023年第12期1559-1564,共6页Chinese Journal of Practical Nervous Diseases

基　　金：成都市医学科研课题(编号:2021221)。

摘　　要：目的探讨老年抑郁症人群认知功能损害与微血管功能障碍的关系。方法选取2020-01—2023-02于成都市第三人民医院治疗的108例老年抑郁症患者为研究对象,其中伴认知功能损害患者48例,不伴认知功能损害患者60例,比较伴和不伴认知功能损害患者临床一般资料、微血管功能障碍相关因素差异。结果伴认知功能损害患者年龄(75.54±5.02)岁,高于不伴认知功能损害患者的(69.03±4.42)岁(P<0.05);伴认知功能损害患者独居比例为47.92%,高于不伴认知功能损害患者的21.67%(P<0.05);伴认知功能损害患者中重度抑郁比例为75.00%,高于不伴认知功能损害患者的40.00%(P<0.05);伴认知功能损害患者同型半胱氨酸(Hcy)为(31.19±8.18)μmol/L,高于不伴认知功能损害患者的(16.65±7.55)mol/L(P<0.05);伴认知功能损害患者半卵圆中心血管周围间隙扩大(EPVS)和基底节区EPVS中重度比例分别为64.58%和66.67%,高于不伴认知功能损害患者的36.67%和41.67%(P<0.05);老年抑郁患者Hcy、半卵圆中心EPVS、基底节区EPVS与MMSE评分呈负相关(P<0.05);老年抑郁患者微血管功能障碍相关因素与抑郁程度评分无相关性(P>0.05);Logistic回归分析显示,年龄、抑郁程度、Hcy和半卵圆中心EPVS是患者发生认知功能损害的影响因素(P<0.05)。结论老年抑郁症人群认知功能损害与微血管功能障碍相关危险因素有关,同时微血管功能障碍相关危险因素Hcy、EPVS与患者认知评分存在相关性。Objective To explore the relationship between cognitive impairment and microvascular dysfunction in elderly depression population.Methods Totally 108 elderly depression patients who were treated in the Third People’s Hospital of Chengdu from January 2020 to February 2023 were selected,including 48 patients with cognitive impairment and 60 patients without cognitive impairment.The differences in clinical general information and factors related to microvascular dysfunction between patients with and without cognitive impairment were compared.Results The age of patients with cognitive impairment was(75.54±5.02)years old,which was higher than that of patients without cognitive impairment(69.03±4.42)years old(P<0.05).The proportion of patients with cognitive impairment living alone was 47.92%,which was higher than that of patients without cognitive impairment 21.67%(P<0.05).The proportion of moderate to severe depression in patients with cognitive impairment was 75.00%,which was higher than that in patients without cognitive impairment 40.00%(P<0.05).The homocysteine(Hcy)of patients with cognitive impairment was(31.19±8.18)μmol/L,which was higher than that of patients without cognitive impairment(16.65±7.55)mol/L(P<0.05).The proportion moderate to severe of enlargement of the perivascular space around the central oval(EPVS)and EPVS in the basal ganglia area of patients with cognitive impairment was 64.58%and 66.67%,respectively,which was higher than those without cognitive impairment 36.67%and 41.67%(P<0.05).There was a negative correlation between Hcy,central oval EPVS,basal ganglia EPVS,and MMSE scores in elderly depression patients(P<0.05).There was no correlation between factors related to microvascular dysfunction and depression severity score in elderly depression patients(P>0.05).Logistic regression analysis showed that age,degree of depression,Hcy,and central oval EPVS were the influencing factors for cognitive impairment in patients(P<0.05).Conclusion Cognitive impairment in elderly depression is associ

关 键 词：老年人 抑郁 微血管功能障碍 认知功能 

分 类 号：R749.13[医药卫生—神经病学与精神病学]