稳定期慢性阻塞性肺疾病患者认知功能相关因素研究

摘要

Objective:To investigate the factors affecting cognitive function in patients with stable chro-nic obstructive pulmonary disease (COPD).Method:135 cases of stable COPD patients were selected from March 2013 to September 2014 in our hospital , and used the Montreal Cognitive Assessment ( MoCA) to e-valuate the cognitive function of stable COPD patients and healthy control population .The level of cognitive function were observed in COPD patients with different lung function , PaO2 and PaCO2 levels.Result: In 135 stable COPD patients , 97 cases had cognitive dysfunction ( 71.85%) .Total score of MoCA Scale in COPD group was (21.55 ±3.63), MoCA total score of the control group was (26.71 ±2.33), the differ-ence was statistically significant (P <0.01).According to the patient lung function, levels of PaO2 and PaCO2 were grouped, MoCA total scores of good lung function group , PaO2≥60 mmHg group, PaCO2<50mmHg group were higher than those in poor lung function group , PaO2<60mmHg group, PaCO2≥50mmHg group.MoCA scores in visuospatial and execution , naming, delayed memory, attention, language, abstract, orientation, and each sub-score were significantly lower in poor lung function group , PaO2<60mmHg group and PaCO2≥50mmHg group.the difference was statistically significant (P <0.05).Linear regression analysis showed that age , education level, lung function, PaO2 levels and PaCO2 levels are the main factors affecting the level of cognitive function in patients with COPD .Conclusion:Cognitive dysfunc-tion in patients with stable COPD is widespread , and worse lung function , lower PaO2 levels and higher PCO2 level are related to the lower MoCA score .Age, education level, lung function, PaO2 and PaCO2 level is the key factors to impact cognitive function of patients with stable COPD .%目的：探讨影响稳定期慢性阻塞性肺疾病（ COPD）患者的认知功能的相关因素。方法：选取2013年3月至2014年9月于我院就诊的稳定期COPD患者135例，采用蒙特利尔认知评估量表（ MoCA）评价稳定期COPD 患者与健康对照人群的认知功能差异，并观察 COPD 患者不同肺功能、PaO2水平及PaCO2水平对患者认知功能的影响。结果：135例稳定期COPD患者中97例（71．85％）患者存在认知功能障碍。 COPD 组MoCA量表总分为（21．55±3．63）分，对照组MoCA总分为（26．71±2．33）分，差异有统计学意义（P＜0．01）。根据患者肺功能情况、PaO2水平及PaCO2水平分别分组，肺功能良好组、PaO2≥60mmHg组、PaCO2＜50mmHg组较肺功能差组、PaO2＜60mmHg 组、PaCO2≥50mmHg组MoCA评分在视空间与执行、命名、延迟记忆、注意、语言、抽象、定向各分项及总分均显著降低，差　　异均有统计学意义（P＜0．05）。线性回归分析显示年龄、文化程度、肺功能、PaO2水平及PaCO2水平是影响慢阻肺患者认知功能的主要因素。结论：稳定期COPD 患者广泛存在认知功能障碍，肺功能越差、PaO2水平越低、PCO2水平越高，MoCA评分越低；年龄、文化程度、肺功能、PaO2水平及PaCO2水平是影响慢阻肺患者认知功能的主要因素。