老年高血压住院患者共病轻度认知功能障碍的危险因素分析  

Study on dangerous factors of mild impairment in cognition among elderly hypertensive patients in hospital

作　　者：杨守红 吕丹 历颖 黄岭葳 何菲[1] YANG Shouhong;LYU Dan;LI Ying;HUANG Lingwei;HE Fei(Department of Geriatrics,Yongchuan Hospital,Chongqing Medical University/Chongqing Clinical Medical Research Center of Geriatric Diseases,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院老年病科/重庆市老年疾病临床医学研究中心,重庆402160

出　　处：《重庆医学》2025年第4期903-909,共7页Chongqing Medical Journal

基　　金：重庆市永川区科技局技术创新与应用发展专项(2021yc-cxfz30017)。

摘　　要：目的探讨老年高血压住院患者合并轻度认知功能障碍(MCI)的危险因素。方法回顾性分析2023年9月至2024年3月在该院老年病科及心血管内科治疗的270例老年高血压患者为研究对象,根据简易精神状态检查(MMSE)量表得分分为高血压合并MCI组(n=142)和高血压未合并MCI组(n=128)。收集并比较两组临床资料和实验室指标水平,采用逐步logistic回归分析老年高血压住院患者合并MCI的危险因素,受试者工作特征(ROC)曲线分析诊断效能。结果老年高血压住院患者合并MCI的患病率为52.6%。单因素分析结果显示,两组不同高血压年限、高血压分级、文化程度、合并糖尿病情况及空腹血糖(FBG)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、HDL-C/低密度脂蛋白-胆固醇(LDL-C)、中性粒细胞计数(NEU)、淋巴细胞计数(LYM)、糖化血红蛋白(HbA1c)、动脉硬化指数(AI)、血浆致动脉粥样硬化指数(AIP)、血脂综合指数(LCI)水平比较,差异有统计学意义(P<0.05)。多因素logistic回归结果显示,高血压分级(3级)、合并糖尿病、NEU、HbA1c、LYM、AIP是老年高血压住院患者发生MCI的影响因素(P<0.05)。FBG、TG、HbA1c、AIP对高血压合并MCI诊断的曲线下面积(AUC)分别为0.801、0.743、0.889、0.804,价值较高。结论可对老年高血压患者发生MCI的影响因素进行早期管理及干预。Objective To investigate the risk factors of mild cognitive impairment(MCI)in elderly patients with hypertension.Methods 270 elderly hypertensive patients treated in the geriatrics department and cardiovascular department of our hospital from September 2023 to March 2024 were analyzed retrospectively.They were divided into hypertension group with MCI(n=142)and hypertension group without MCI(n=128)according to the score of the simple mental state examination(MMSE).The clinical data and laboratory indicators of the two groups were collected and compared.The risk factors of MCI in elderly hospitalized patients with hypertension were analyzed by stepwise logistic regression,and the diagnostic efficiency was analyzed by receiver operating characteristic(ROC)curve.Results The prevalence rate of MCI in elderly patients with hypertension was 52.6%.The monofactor analysis showed that the two groups had different hypertension years,hypertension grade,education level,combined diabetes,fasting blood glucose(FBG),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),HDL-C/low density lipoprotein-cholesterol(LDL-C),neutrophil(NEU),lymphocyte(LYM),glycated hemoglobin(HbA1c),arteriosclerosis index(AI),atherogenic index of plasma(AIP)and lipid composite index(LCI),the differences were statistically significant(P<0.05).Multivariate logi stic regression results showed that hypertension grade(grade 3),diabetes mellitus,NEU,HbA1c,LYM and AIP were the influencing factors for MCI in elderly hospitalized patients with hypertension(P<0.05).The area under the curve(AUC)of FBG,TG,HbA1c and AIP in the diagnosis of hypertension combined with MCI were 0.801,0.743,0.889 and 0.804,respectively.Conclusion Early management and intervention can be carried out on the influencing factors of MCI in elderly patients with hypertension.

关 键 词：老年人 高血压 轻度认知功能障碍 血浆致动脉粥样硬化指数 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]