CHF合并MCI患者神经心理学特征及相关因素分析  

Neuropsychological characteristics and related factors in patients with congestive heart failure complicated by mild cognitive impairment

作　　者：冯攀 刘涛 王毅博 张婷 徐楷 Feng Pan;Liu Tao;Wang Yibo;Zhang Ting;Xu Kai(Department of Cardiology,Baoji Hospital of Traditional Chinese Medicine,Baoji 721000,Shaanxi Province,China)

机构地区：[1]宝鸡市中医院心血管内科,宝鸡721000

出　　处：《中国基层医药》2025年第3期382-386,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：陕西省卫生健康科研基金(2018D009)。

摘　　要：目的分析慢性心力衰竭(CHF)合并轻度认知障碍(MCI)患者神经心理学特征,探讨影响CHF合并MCI的相关因素。方法采用病例对照研究,回顾性分析宝鸡市中医院2019年1月至2020年10月收治的CHF患者98例的临床资料,依据Petersen MCI筛查标准分为MCI组(n=48)、认知功能正常组(NC组,n=50),用简易智能状态量表(MMSE)、蒙特利尔认知评估量表(MOCA)分析神经心理学特征,测试并比较两组患者的认知域评分,logistic回归分析CHF合并MCI的影响因素。结果NC组MMSE、MoCA总分分别为(28.45±1.10)分、(27.90±1.35)分,均高于MCI组的(23.50±2.25)分、(22.95±1.35)分(t=13.92、18.15,均P<0.001);NC组正确阅读数、耗时数、注意力、视空间功能、记忆力、语言功能均优于MCI组(t=2.94、7.29、3.15、9.90、14.69、4.87,均P<0.01);MCI组年龄≥65岁、文化程度初中及以下、睡眠障碍、纽约心脏病协会分级Ⅲ级占比均高于NC组(χ^(2)=4.18、4.08、6.88、4.70,均P<0.05),心输出量(CO)低于NC组(t=4.70,P<0.05);logistic回归分析显示,年龄≥65岁(OR=3.904,95%CI:1.530~9.963)、文化程度初中及以下(OR=2.565,95%CI:1.571~4.187)、睡眠障碍(OR=3.080,95%CI:1.445~6.564)、CO低(OR=1.784,95%CI:1.168~2.725)为CHF合并MCI的独立危险因素(均P<0.05)。结论CHF合并MCI患者的视空间功能、执行功能、注意力、语言功能、记忆力区域的损害更多见;年龄≥65岁、文化程度初中及以下、睡眠障碍、CO低等为CHF合并MCI的独立危险因素。Objective To analyze the neuropsychological characteristics of patients with chronic heart failure(CHF)complicated by mild cognitive impairment(MCI)and investigate the factors that influence the development of CHF complicated by MCI.Methods A case-control study was conducted to retrospectively analyze the clinical data of 98 patients with CHF admitted to Baoji Hospital of Traditional Chinese Medicine from January 2019 to October 2020.Based on the Petersen MCI screening criteria,the patients were divided into the MCI group(n=48)and the normal cognitive group(NC group,n=50).The neuropsychological characteristics were analyzed using the Mini-Mental State Examination and the Montreal Cognitive Assessment.The cognitive domain scores of the two groups were tested and compared.Logistic regression analysis was performed to identify the factors influencing the development of CHF complicated by MCI.Results The total scores of the Mini-Mental State Examination and the Montreal Cognitive Assessment in the NC group were 28.45±1.10 and 27.90±1.35,respectively,which were significantly higher than those in the MCI group(23.50±2.25,22.95±1.35,t=13.92,18.15,both P<0.001).In addition,the NC group outperformed the MCI group in terms of the number of correct readings,time taken,attention,visuospatial function,memory,and language function(t=2.94,7.29,3.15,9.90,14.69,4.87,all P<0.01).The MCI group had a greater proportion of patients who were aged≥65 years,had an education level of junior high school or below,experienced sleep disorders,and were classified as New York Heart Association(NYHA)functional classⅢ,compared with the NC group(χ^(2)=4.18,4.08,6.88,4.70,all P<0.05).Additionally,the cardiac output was lower in the MCI group than in the NC group(t=4.70,P<0.05).Logistic regression analysis revealed that age≥65 years(OR=3.904,95%CI:1.530-9.963),education level of junior high school or below(OR=2.565,95%CI:1.571-4.187),sleep disorders(OR=3.080,95%CI:1.445-6.564),and low cardiac output(OR=1.784,95%CI:1.168-2.725)were indepe

关 键 词：心力衰竭 认知功能障碍 神经心理学 疾病特征 危险因素 因素分析 统计学 

分 类 号：R74[医药卫生—神经病学与精神病学]