不同CHA2DS2-VASc-60评分的心房颤动患者轻度认知障碍情况分析  

Mild cognitive impairment in atrial fibrillation patients at different CHA2DS2-VASc-60 scores

作　　者：王学英 刘晓霞 赖杰 王佳 WANG Xue-ying;LIU Xiao-xia;LAI Jie;WANG Jia(Department of Rehabilitation,Emergency General Hospital,Beijing 100028;General Medicine Department,Emergency General Hospital,Beijing 100028,China;Department of cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]应急总医院康复医学科,北京市100028 [2]应急总医院综合医疗科,北京市100028 [3]首都医科大学附属北京安贞医院心内科

出　　处：《中国心血管病研究》2024年第6期554-559,共6页Chinese Journal of Cardiovascular Research

基　　金：应急总医院医学发展科研基金(K202113、K201910)。

摘　　要：目的 了解不同CHA2DS2-VASc-60评分的心房颤动(房颤)患者轻度认知障碍的情况。方法 纳入125例自2022年10月至2023年06月间就诊于应急总医院心内科及综合医疗科无视力及听力障碍的房颤患者,进行卒中风险评分,根据评分结果分为卒中低风险组和卒中中、高风险组,三组同时完成记忆力、注意力、语言功能、执行功能、视空间功能、日常生活能力的评估。比较三组患者轻度认知障碍的情况。结果卒中低风险组25例,平均年龄(60.2±3.9)岁,卒中中风险组39例,平均年龄(61.6±5.7)岁,卒中高风险组61例,平均年龄(66.9±5.8)岁,三组患者在教育水平(有效年限)、房颤病程、血红蛋白、谷丙转氨酶、甘油三酯、胆固醇、同型半胱氨酸、肌酐、钠离子、D-二聚体、促甲状腺激素方面比较差异均无统计学意义(P>0.05)。经认知功能评估后发现,卒中低风险组14例存在轻度认知障碍(56.0%);卒中中风险组18例存在轻度认知障碍(46.2%),高风险组38例存在轻度认知障碍(62.3%),三组发生轻度认知障碍的风险无差异(F=2.516,P=0.284),但在卒中低风险组与其他两组之间短时记忆方面存在明显差异(P<0.05)。结论:房颤人群轻度认知障碍患病率明显增高,且卒中风险高的患者更易发生短时记忆下降。在房颤人群中,无论卒中风险高低均有发生轻度认知障碍的风险,合理有效的抗凝治疗可能会降低认知下降的风险。Objective To investigate the present situation of mild cognitive impairment in atrial fibrillation patients at different CHA2DS2-VASc-60 scores.Methods A total of 125 atrial fibrillation patients admitted to The Emergency General Hospital from October 2022 to June 2023 were assessed for stroke,completed the evaluation of the five neuropsychological scales of cognitive domain including memory,attention,language,execution and visual space function as well as risk factors based on CHA2DS2-VASc-60 score.They were divided into the high stroke risk group,moderate stroke risk group and low stroke risk group.The baseline characteristics and the present situation of mild cognitive impairment in the patients were analyzed.Results There were 25 cases in the low stroke risk group,and the average age was(60.2±3.9)years;there were 39 cases in the moderate stroke risk group,and the average age was(61.6±5.7)years;there were 61 cases in the high stroke risk group,and the average age was 66.9±5.8 years.Among the patients there were no statistical significance in age,education level,the AF duration,hemoglobin,liver and kidney function,blood lipid levels,electrolyte levels,thyroid function,homocysteine levels and D-dimer(P>0.05).14 patients(56%)had mild cognitive impairment in the low-risk stroke group;18 patients(46.2%)had mild cognitive impairment in the moderate-risk stroke group;38 people existed mild cognitive impairment in the high risk stroke group(62.3%).There were no significant difference among the three groups(F=2.516,P=0.284),but there was a significant difference in the short-term memory between the low-risk group and the other two groups(P<0.05).Conclusion The prevalence of mild cognitive impairment in AF patients is higher.Patients with a high risk of stroke are more prone to short-term memory decline.Effective anticoagulation may reduce the risk of cognitive decline.

关 键 词：心房颤动 卒中风险评分(CHA2DS2-VASc-60) 轻度认知功能障碍 

分 类 号：R541.7[医药卫生—心血管疾病]