降压治疗后续效应对老老年高血压患者认知功能的影响

摘要

Objective To investigate the post effects of anti-hypertension treatment on cognition function in very elderly persons with hypertension. Methods A total of 194 cases of elderly hypertensive patients were enrolled and divided into two groups. During the treatment period of 5 years , the individuals of treatment group ( n = 105 ) were given indapam-ide or combination of perindopril to antihypertensive treatment. The individuals of control group ( n = 89) were given inda-pamide placebo or combination of perdopriol placebo. The next 2 years open treatment was given to all individuals. During the open treatment, no patients intervened and all patients were followed up regularly. Cognition function was evaluated by mini-mental state examination (MMSE). Results During open treatment, 18 cases died (16.67% ) in treatment group, 14 cases died in the control group (15.73%) , P>0.05. At the initiation of open treatment, the scores of MMSE, orientation, memory capablity, attention and calculation, language ability of treatment group were higher than those in control group (P <0. 01). At the end of the open treatment, the scores of MMSE, orientation, immediate memory, attention and calculation ability, recollection , language ability of two groups were lower than those of the beginning of open treatment (all P <0. 01) . The decline rate of MMSE,orientation, memory capablity, attention and caculation in the drug treatment group were significantly lower than those in control group ( all P <0.01) . Conclusion There are post effects of anti-hypertension. The post effects of anti-hypertension may be slow down the demage of cognition function in very elderly hypertensive patients.%目的 探讨降压治疗后续效应对老老年高血压患者认知功能的影响.方法 老老年高血压患者194例,5年降压治疗期间治疗组(105例)单用吲达帕胺或合用培哚普利降压治疗,对照组(89例)单用吲达帕胺安慰剂或合用培哚普利安慰剂.主试验结束后进行2年开放治疗,患者自主服药,不对其进行干预,定期随访.开放治疗始末采用简易精神状态检查量表(MMSE)对两组患者的认知功能进行评价.结果 开放治疗期间治疗组死亡18例(16.67％),对照组14例(15.73％),两组病死率相比,P＞0.05.开放治疗起始,治疗组MMSE总分、定向力、即刻记忆力、注意力和计算力、语言能力评分均高于对照组(P均＜0.01)；开放治疗末,两组MMSE总分、定向力、即刻记忆力、注意力和计算力、记忆力、语言能力评分均低于开放治疗始(P均＜0.01).治疗组MMSE总分、定向力、即刻记忆力、注意力和计算力评分变化率低于对照组(P均＜0.01).结论 对老老年高血压患者进行降压治疗,其后续效应可以延缓患者认知功能的下降.