中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2013, Vol. 42 ›› Issue (11): 974–977.

• 论著 • 上一篇    下一篇

老年脑白质疏松患者认知功能与心血管危险因素关系的研究

王晓楠,欧风荣,王春雷1   

  1. 中国医科大学附属第一医院1.老年病科;
    2.营养科,沈阳110001
  • 收稿日期:2013-07-16 出版日期:2013-11-30 发布日期:2013-11-28
  • 作者简介:13897953079王晓楠(1981-),女,主治医师,博士.
  • 基金资助:
    国家自然科学基金(81200246),高等学校博士学科点专项科研基金(20122104120004)

Study of the Relationship between Cognitive Function and Cardiovascular Risk Factors in Elderly Patients with Leukoaraiosis

WANG Xiao-nan1,OU Feng-rong2,WANG Chun-lei1   

  1. 1. Department of Gerontology and Geriatrics,The First Hospital,China Medical University,Shenyang 110001,China;
    2. Department of Clinical Nutrition,The First Hospital,China Medical University,Shenyang,110001,China
  • Received:2013-07-16 Online:2013-11-30 Published:2013-11-28

摘要: 目的探讨老年脑白质疏松(LA)患者认知功能与心血管危险因素的关系。方法选择2011年8月至2013年6月在中国医科大学附属第一医院老年病科住院的LA患者147例和非LA患者(对照组)42例,利用Framingham危险评分(FRS)方程评价其心血管危险因素,计算FRS积分值,估测未来10年冠心病的发生风险。根据估测结果将老年LA患者分为低危组(风险<10%)、中危组(10%~20%)和高危组(>20%);采用简易精神状态量表(MMSE),蒙特利尔认知评估中文版(MoCA)和日常生活能力量表(ADL)评估认知功能,比较不同危险分组间的认知功能水平。结果对照组的FRS积分值、MMSE评分、MoCA评分及ADL评分分别为(16.32#x000b1;4.10),(27.24#x000b1;1.21),(25.32#x000b1;1.31),(20.26#x000b1;1.02)分;与对照组比较,LA组的FRS积分值(20.64#x000b1;2.67分)及ADL评分(22.43#x000b1;1.16)显著升高(P均<0.05),MMSE评分(25.13#x000b1;1.46分)及MoCA评分(20.26#x000b1;1.54)显著降低(P均<0.05)。在LA患者中,低危组FRS积分值、MMSE评分及MoCA评分分别为(17.21#x000b1;1.81)、(26.59#x000b1;1.02)、(22.14#x000b1;1.01)分;与低危组比较,中危组FRS积分值(19.27#x000b1;2.17分)显著升高,MMSE评分(25.32#x000b1;1.53分)及MoCA评分(20.84#x000b1;1.36)显著降低(P均<0.05),高危组FRS积分值(22.36#x000b1;2.01分)显著高,MMSE评分(23.62#x000b1;1.03分)及MoCA评分(18.36#x000b1;1.25)显著降低(P均<0.05);与中危组比较,高危组FRS积分值显著升高,MMSE评分及MoCA评分显著降低(P均<0.05);FRS积分值与认知功能(MMSE评分及MoCA评分)呈负相关,相关系数分别为-0.143(P<0.05)及-0.156(P<0.05)。结论老年LA患者心血管危险因素增高,且心血管危险因素与认知功能存在负相关,危险因素的项目越多,程度越重,FRS积分值越高,认知功能水平及日常生活能力越低。

关键词: 脑白质疏松, 心血管危险因素, 认知功能

Abstract: Objective To explore the relationship between cardiovascular risk factors and cognitive function in elderly patients with leukoaraiosis (LA). Methods A total of 147 elderly persons with LA and 42 elderly non-LA individuals were selected from the Departments of Gerontology and Geriatrics of the First affiliated Hospital of China Medical University between August 2011 and Jun 2013. The Framingham gender-specific risk equation was employed to evaluate the cardiovascular risk factors,calculate Framingham risk score (FRS) and estimate the risk of 10-year coronary heart disease (CHD). A total of 147 elderly patients with LA were divided into 3 groups according to 10-year CHD risk: low risk (<10%),moderate risk (10%~20%) and high risk groups (>20%). Mini-mental state examination (MMSE),Montreal Cognitive Assessment (MoCA),and the activities of daily living (ADL) were used to evaluate the cognitive function; cognitive function among different risk groups were compared,and the correlation coefficients between FRS and cognitive function were calculated. Results FRS,MMSE score and MoCA score in the control group was(16.32#x000b1;4.10),(27.24#x000b1;1.21),and(25.32#x000b1;1.31)Compared with the control group,FRS (20.64#x000b1;2.67) increased significantly (P<0.05),MMSE score (25.13#x000b1;1.46) and MoCA score (20.26#x000b1;1.54) decreased significantly (P<0.05) in LA group. In elderly LA patients,FRS,MMSE score and MoCA score in the low risk group was (17.21#x000b1;1.81),(26.59#x000b1;1.02),and (22.14#x000b1;1.01); Compared with the low risk group,FRS (19.27#x000b1;2.17) increased significantly (P<0.05),MMSE score (25.32#x000b1;1.53) and MoCA score (20.84#x000b1;1.36) decreased significantly (P<0.05) in moderate risk group,FRS (22.36#x000b1;2.01) increased significantly (P<0.05),MMSE score (23.62#x000b1;1.03) and MoCA score (18.36#x000b1;1.25) decreased significantly (P<0.05) in high risk group; Compared with the moderate risk group,FRS increased significantly (P<0.05),MMSE score and MoCA score decreased significantly (P<0.05) in high risk group. There was a significantly inverse correlation between FRS and cognitive function with the Pearson correlation coefficients at -0.143 (MMSE score,P<0.05) and -0.156(MoCA,P<0.01). Conclusion An inverse correlation exists between cardiovascular risk factors and cognitive function in healthy population. With more risk factors and greater severity,FRS increases while cognitive function and activities of daily living decreases.

Key words: leukoaraiosis, cardiovascular risk factors, cognitive impairment

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