血压变异性对合并高血压老年精神分裂症患者认知功能恶化的影响  

Effect of blood pressure variability on cognitive function deterioration in elderly patients with schizophrenia complicated with hypertension

作　　者：王玲 陈菲菲 陈慧琴 WANG Ling;CHEN Fei-fei;CHEN Hui-qin(Ward Eight of Geriatric Psychiatry,Lishui Second People's Hospital,Lishui 323000,China)

机构地区：[1]浙江省丽水市第二人民医院老年精神科八病区,323000

出　　处：《临床精神医学杂志》2025年第2期125-128,共4页Journal of Clinical Psychiatry

基　　金：国家卫生健康委医药卫生科技发展研究项目(WKZX2022JG0105)。

摘　　要：目的:探讨血压变异性(blood pressure variability,BPV)对合并高血压老年精神分裂症患者认知功能恶化的影响。方法:将96例老年精神分裂症合并高血压患者作为研究对象,均接受为期1年的随访,采用简易精神状态检查量表(mini-mental state examination scale,MMSE)评估患者入组时、入组1年后的认知功能,MMSE评分差值≤4分为缓慢恶化组(n=57),MMSE评分差值>4分为快速恶化组(n=39)。比较两组的临床资料、BPV参数[24 h内平均收缩压(mean systolic blood pressure,24 h SBP)、平均舒张压(mean diastolic blood pressure,24 h DBP)、脉压、24 h SBP-变异系数(coefficient of variation,CV)、24 h DBP-CV和脉压变异系数]。采用多因素Logistic回归分析患者认知功能快速恶化的危险因素。结果:缓慢恶化组和快速恶化组患者24 h SBP、脉压、24 h SBP-CV、24 h DBP-CV、脉压-CV以及血压昼夜节律类型比较,差异均有统计学意义(P均<0.05)。阳性和阴性症状量表得分、24 h SBP、脉压、24 h SBP-CV、24 h DBP-CV、脉压-CV均是老年高血压合并精神分裂患者认知功能快速恶化的危险因素(P均<0.05)。结论:BPV参数是老年高血压合并精神分裂症患者认知功能恶化的危险因素,临床应加强对患者血压波动的管理,以延缓认知功能恶化。Objective:To investigate the effect of blood pressure variability(BPV)on the deterioration of cognitive function in elderly patients with schizophrenia complicated with hypertension.Method:A total of 96 elderly patients with schizophrenia and hypertension were enrolled in the study.All patients were followed up for one year.The mini-mental state examination scale(MMSE)was used to evaluate the cognitive function of the patients at the time of enrollment and one year after enrollment.The MMSE score difference≤4 was divided into the slow deterioration group(n=57),and the MMSE score difference>4 was divided into the rapid deterioration group(n=39).The clinical data,BPV parameters[24 h mean systolic blood pressure(24 h SBP),24h mean diastolic blood pressure(24 h DBP),pulse pressure,24 h SBP-coefficient of variation(CV),24 h DBP-CV and pulse pressure variation coefficient]were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the risk factors of rapid deterioration of cognitive function in patients.Results:There were significant differences in 24 h SBP,pulse pressure,24 h SBP-CV,24 h DBP-CV,pulse pressure-CV and circadian rhythm of blood pressure between the slow deterioration group and the rapid deterioration group(all P<0.05).Multivariate logistic regression analysis showed that the positive and negative syndrome scale score,24 h SBP,pulse pressure,24 h SBP-CV,24 h DBP-CV and pulse pressure-CV were risk factors for rapid deterioration of cognitive function in elderly patients with hypertension and schizophrenia(all P<0.05).Conclusion:BPV parameter is a risk factor for the deterioration of cognitive function in elderly patients with hypertension and schizophrenia.Clinical management of blood pressure fluctuations in patients should be strengthened to delay the deterioration of cognitive function.

关 键 词：精神分裂症 认知功能 血压变异性 高血压 

分 类 号：R749.3[医药卫生—神经病学与精神病学]