老年高血压患者认知功能与动态血压指标的关系

摘要

目的 探讨老年高血压患者认知功能与动态血压指标的关系.方法 选取2017年4月至2018年3月就诊于华北理工大学附属医院老年病科、神经内科、心内科住院的老年高血压病患者350例,通过微型心理状态检查(MMSE)进行评估,按照微型心理状态检查MMSE评分结果分为认知功能障碍组和认知功能正常组(对照组),两组入选对象均进行24 h动态血压的检查.结果 在控制性别、年龄、受教育年限、体质指数、总胆固醇、尿酸、血红蛋白、同型半胱氨酸因素的影响后,认知功能障碍组总舒张压较对照组无明显差异,总平均收缩压、总平均脉压高于对照组,两组昼夜节律类型差别有统计学意义(P＜0.05).总平均收缩压(OR=1.086,95%CI:1.048~1.125)、总平均脉压(OR=1.419,95%CI:1.292~1.558)、昼夜节律(OR=1.383,95%CI:1.049~1.824)与老年高血压病患者认知功能障碍独立密切相关.结论 收缩压、脉压、昼夜节律是老年高血压患者认知功能障碍的独立预测因子.%To explore the relationship between the changes of dynamic blood pressure index and cognitive function level in elderly patients with hypertension. Method 350 senile hypertension patients from the affiliated hospital of North China University of Science and Technology, where the neurology and internal medicines were selected at April 2017 to March 2018. The MMSE was evaluated by the micropsychological state examination (MMSE). According to the MMSE score, patients were divided into cognitive dysfunction group and cognitive function group, which was defined as cognitive dysfunction group and control group, respectively. Two groups were examined for 24-hour dynamic blood pressure. Results After controlling for gender, age, years of schooling, BMI, TC, UA, HGB, Hcy factors, the total diastolic blood pressure in the cognitive dysfunction group was not significantly different from the control group, and the total mean systolic blood pressure and total mean pulse pressure were higher. In the control group, the difference in circadian rhythm between the two groups was statistically significant (P<0.05). Total mean systolic blood pressure (OR=1.086, 95%CI:1.048~1.125), total mean pulse pressure (OR=1.419, 95%CI:1.292~1.558), circadian rhythm (OR=1.383, 95%CI:1.049~1.824) were independently and closely related with cognitive dysfunction in senile hypertension patients. Conclusion Systolic blood pressure, pulse pressure and circadian rhythm change are independent predictors of cognitive dysfunction in elderly patients with hypertension.