| 刘霞,张雪莲,刘巧玲.血压变异性对老年高血压合并脑小血管病患者认知功能的影响[J].中国临床保健杂志,2023,26(5):642-646. |
| 血压变异性对老年高血压合并脑小血管病患者认知功能的影响 |
| The effect of blood pressure variability on cognitive function in elderly patients with hypertension complicated with cerebral small vessal disease |
| 投稿时间：2023-04-03 |
| DOI：10.3969/J.issn.1672-6790.2023.05.014 |
| 中文关键词: 高血压 大脑小血管疾病 认知功能障碍 危险因素 老年人 |
| 英文关键词: Hypertension Cerebral small vessel diseases Cognitive dysfunction Risk factors Aged 〖FL |
| 基金项目:江苏省卫生健康委科研项目(BJ19010) |
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| 中文摘要: |
| 目的 探讨血压变异性对老年高血压合并脑小血管病(CSVD)患者认知功能的影响。方法 选择289例老年高血压患者作为研究对象,根据是否合并CSVD分为单纯高血压组和高血压合并CSVD组。根据蒙特利尔认知评估量表(MoCA),高血压合并CSVD组患者被分为认知功能障碍组和认知功能正常组,比较3组患者的一般临床资料及生化指标；分析血压变异性对老年高血压合并CSVD患者认知功能的影响,用logistic回归分析法筛选出CSVD患者认知功能障碍的危险因素。结果 3组间一般临床资料比较,差异无统计学意义(P>0.05)。认知功能障碍组的同型半胱氨酸(Hcy)、胱抑素C(Cys C)水平均明显高于认知功能正常组(P<0.05)。认知功能障碍组24 h平均收缩压、24 h平均收缩压变异系数、24 h平均脉压、日间平均收缩压、日间平均脉压、夜间平均收缩压、夜间平均脉压高于认知功能正常组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示24 h平均收缩压标准差、24 h平均收缩压变异系数是CSVD患者认知功能障碍的危险因素(P<0.05)。结论 高血压合并CSVD患者Hcy及Cys C水平与认知功能密切相关,24 h平均收缩压标准差、24 h平均收缩压变异系数是CSVD患者的独立危险因素,可为临床诊断和治疗提供新思路。 |
| 英文摘要: |
| Objective To investigate the effect of blood pressure variability on cognitive function in elderly patients with hypertension complicated with cerebral small vessel disease (CSVD).Methods Two hundred and eighty nine elderly patients with hypertension were included in this study.According to whether CSVD was present,the patients were divided into a simple hypertension group and a hypertension combined with CSVD group.The cognitive function of patients with CSVD was decided according to the MoCA score.General clinical data,blood glucose,blood lipid,liver and renal function,homocysteine (Hcy) level,cystatin C (Cys C),and MoCA scores were compared between groups.The effects of blood pressure variability on cognitive function in elderly patients with hypertension complicated with CSVD were analyzed,and the risk factors of cognitive dysfunction in CSVD patients were screened by Logistic regression analysis.Results There was no statistical difference in general data among the three groups (P>0.05).The levels of Hcy and Cys C in the cognitive dysfunction group were significantly higher than those in the normal cognitive function group (P<0.05).The 24 h mean systolic blood pressure,24 h mean systolic blood pressure coefficient of variation,24 h mean pulse pressure,daytime mean systolic blood pressure,daytime mean pulse pressure,night mean systolic blood pressure,and night mean pulse pressure in the cognitive dysfunction group were higher than those in the normal cognitive function group,and the differences were statistically significant (P<0.05).Multivariate Logistic analysis showed that the standard deviation of 24 h means systolic blood pressure,and coefficient of variation of 24 h mean systolic blood pressure were risk factors for cognitive dysfunction in patients with CSVD (P<0.05).Conclusions The plasma levels of Hcy and Cys C in patients with hypertension complicated with CSVD are closely correlated to cognitive function.The standard deviation of 24 h mean systolic blood pressure,and coefficient of variation of 24 h mean systolic blood pressure are independent risk factors for patients with CSVD,and they can provide new ideas for clinical diagnosis and treatment. |
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