谢玉芳 杨凤 黄小红 刘仕翔

[摘要] 目的 探討老年高血压患者轻度认知功能障碍受到合并脑血管血流动力学异常的影响。方法 回顾性选取2018年6月至2020年6月本院老年高血压患者60例，依据合并脑血管血流动力学异常情况分为合并组（n=30）、未合并组（n=30）两组，另回顾性选取同期本院老年非高血压人群30例作为对照组，统计分析三组人员的血压、血糖、血脂、CVHI评分、认知功能，二元Logistic回归分析轻度认知功能障碍的影响因素。结果 合并组、未合并组、对照组人员的收缩压、舒张压、空腹血糖水平均逐渐降低（P<0.05），CVHI评分逐渐升高（P<0.05），但三组人员的总胆固醇、LDL-C水平比较，差异无统计学意义（P>0.05）。合并组患者的定向力、抽象思维评分均显著低于未合并组、对照组，差异有统计学意义（P<0.05）;合并组、未合并组患者的语言、命名、视空间与执行功能、注意与集中、延迟记忆评分均显著低于对照组，差异有统计学意义（P<0.05）;合并组、未合并组、对照组人员的MoCA总分逐渐升高（P<0.05）。轻度认知功能障碍的影响因素包括糖尿病、教育年限≤12年、最小流速、CVHI异常、高血压合并CVHI异常（P<0.05）。结论 老年高血压患者轻度认知功能障碍受到合并脑血管血流动力学异常的直接影响。

[关键词] 老年;高血压;轻度认知功能障碍;脑血管血流动力学异常;血压;血糖;血脂

[中图分类号] R749.1          [文献标识码] B          [文章编号] 1673-9701（2021）32-0117-04

[Abstract] Objective To investigate the effect of cerebrovascular hemodynamic abnormalities on mild cognitive impairment in elderly hypertensive patients. Methods A total of 60 elderly patients with hypertension in our hospital from June 2018 to June 2020 were retrospectively selected and divided into the combined group （n=30） and the uncombined group（n=30） based on abnormal cerebrovascular hemodynamics. Another 30 elderly non-hypertensive people in our hospital during the same period were retrospectively selected as the control group. The blood pressure， blood glucose， blood lipids， CVHI score， the cognitive function of the three groups were statistically analyzed. Binary Logistic regression was used to analyze the influencing factors of mild cognitive dysfunction. Results The systolic blood pressure， diastolic blood pressure， and fasting blood glucose levels of the combined group， uncombined group， and control group gradually decreased （P<0.05）， and the CVHI score gradually increased （P<0.05）. But the differences in the total cholesterol and LDL-C levels of the three groups were not significant （P>0.05）. The orientation and abstract thinking scores of patients in the combined group were significantly lower than those in the uncombined group and the control group，the difference was statistically significant （P<0.05）. The language， naming， visual space and executive function， attention and concentration， and delayed memory scores of patients in the combined and uncombined groups were significantly lower than those of the control group，the difference was statistically significant （P<0.05）. The total MoCA scores of the combined， uncombined， and control group gradually increased（P<0.05）. The influencing factors of mild cognitive dysfunction included diabetes， education years≤12 years， minimum flow rate， abnormal CVHI， and abnormal CVHI combined with hypertension（P<0.05）. Conclusion Mild cognitive dysfunction in elderly hypertensive patients is directly affected by abnormal cerebrovascular hemodynamics.

[Key words] Old age; Hypertension; Mild cognitive impairment; Abnormal cerebrovascular hemodynamics; Blood pressure; Blood glucose; Blood lipids

高血压属于一种慢性疾病，老年人是高发人群，对老年人的生命质量造成了严重危害[1]。老年高血压患者普遍具有异常的脑血流动力学，有显著脑血管损害存在的患者占总数的40%～50%，极易引发患者认知功能障碍[2]。……