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中华心脏与心律电子杂志

中华心脏与心律电子杂志 ›› 2017, Vol. 05 ›› Issue (03) : 166 -168. doi: 10.3877/cma.j.issn.2095-6568.2017.03.011

所属专题： 文献；

论著

老年餐后低血压患者与轻度认知功能障碍的关系探讨
姜娟1, 魏雅楠1,†(), 邓利华1, 陈源源2, 宝辉1, 刘杰1, 王晶桐1   
  1. 1. 100044　北京大学人民医院老年科
    2. 北京大学人民医院心内科
  • 出版日期:2017-09-25
  • 通信作者: 魏雅楠
  • 基金资助:
    北京大学人民医院研究与发展基金资助课题，"老年人夜间间断低氧血症对认知功能的影响"(编号2147000069)

Relationship Between Postprandial Hypotension and Mild Cognitive Impairment in elderly patients

Juan Jiang1, Yanan Wei1,†(), Lihua Deng1, Yuanyuan Chen2, Hui Bao1, Jie Liu1, Jingtong Wang1   

  1. 1. Department of Geriatrics, Peking University People′s Hospital, Beijing, 100044, China
    2. Department of Cardiology, Peking University People′s Hospital, Beijing, 100044, China
  • Published:2017-09-25
  • Corresponding author: Yanan Wei
  • About author:
    Corresponding author: Wei Yanan, Email:
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姜娟, 魏雅楠, 邓利华, 陈源源, 宝辉, 刘杰, 王晶桐. 老年餐后低血压患者与轻度认知功能障碍的关系探讨[J]. 中华心脏与心律电子杂志, 2017, 05(03): 166-168.

Juan Jiang, Yanan Wei, Lihua Deng, Yuanyuan Chen, Hui Bao, Jie Liu, Jingtong Wang. Relationship Between Postprandial Hypotension and Mild Cognitive Impairment in elderly patients[J]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2017, 05(03): 166-168.

目的

探讨老年餐后低血压患者与轻度认知功能障碍(MCI)的关系。

方法

老年住院患者296例，年龄60～95(78.95±8.18)岁，其中男性194例(65.5%)。每隔30 min测量三餐后2 h内血压，根据是否符合餐后低血压(PPH)标准分为对照组和PPH组。采用协和版蒙特利尔认知评估量表(MoCA-P)评估其认知功能，根据MCI诊断标准分为认知功能正常(NC)组和MCI组。分析PPH与MCI的关系。

结果

296例患者中，符合PPH标准有146例(49.3%)，MoCA得分低于分界值有125例(42.2%)。PPH组MoCA得分低于非PPH组(24.76±3.96比25.66±2.98，P＝0.028)。PPH组MCI发生率高于非PPH组(50.7%比34%，P＝0.005)。Logstic回归分析显示，年龄、受教育年限和PPH与MCI独立相关[OR(95%CI)分别为1.06(1.02～1.11)，0.83(0.76～0.90)，1.98(1.16～3.36)，均P<0.05]。

结论

PPH可能是老年患者轻度认知功能障碍的独立危险因素。

关键词: 餐后低血压, 轻度认知功能障碍, 动态血压
Objectives

To explore the relationship between postprandial hypotension (PPH) and mild cognitive impariment(MCI) in elderly patients.

Methods

296 senile inpatients with mean age of 78.95 years (range from 60 to 95 years) were recruited. 194 patients were male (65.5%). Their postprandial blood pressures were measured every 30 minutes, and then divided into 2 groups according to the definition of PPH: PPH group and non-PPH group. Cognitive function was assessed by Peking Union Medical College Hospital vision of Montreal Cognitive Assessment (MoCA-P), then divided into 2 groups according to the definition of MCI: MCI group and normal cognition (NC) group.

Results

There are 146 patients met PPH criteria (49.3%). 125 patients had MCI (42.2%). Compared with the non-PPH group, the PPH group had lower MoCA score (24.76±3.96 vs 25.66±2.98, P=0.028). The incidence of MCI in PPH group was significantly higer than in non-PPH group (50.7% vs 34%, P=0.005). Logistic regression analysis showed that age, average education years and PPH independently correlated with MCI [OR(95%CI) was 1.06(1.02-1.11), 0.83(0.76-0.90), 1.98(1.16-3.36) respectively, all P<0.05].

Conclusion

PPH may be an independent risk factor for MCI in elderly patients.

Key words: Postprandial hypotension, Mild cognitive impariment, Ambulatory blood pressure
表1 PPH组和非PPH组一般临床资料比较 (±s)
项目 PPH组(146例) 非PPH组(150例) P值
男/女(例数) 94/52 100/50 0.386
年龄(岁) 81.30±6.88 76.66±8.71 <0.001
BMI(kg/m2) 24.13±3.34 23.86±3.38 0.484
eGFR[ml/(min·1.73 m2)] 66.51±18.96 74.562±17.10 <0.001
24 h平均收缩压(mmHg) 126.51±13.77 121.45±13.30 0.001
24 h平均舒张压(mmHg) 67.40±7.19 67.37±7.49 0.978
24 h平均脉压(mmHg) 59.12±11.95 54.07±11.65 <0.001
高血压[例(%)] 112(76.7) 102(68) 0.061
冠心病[例(%)] 62(42.5) 59(39.3) 0.334
糖尿病[例(%)] 69(47.3) 85(56.7) 0.130
降压药物[例(%)] 114(78.1) 105(70) 0.145
钙拮抗剂[例(%)] 62(42.5) 59(39.3) 0.637
β受体阻滞剂[例(%)] 51(34.9) 46(30.7) 0.459
ACEI[例(%)] 2(1.4) 8(5.3) 0.104
ARB[例(%)] 64(43.8) 51(34) 0.095
利尿剂[例(%)] 19(13.1) 18(12) 0.861
表2 PPH组和非PPH组认知功能比较 (±s)
项目 PPH组(146例) 非PPH组(150例) P值
MoCA评分(分) 24.76±3.96 25.66±2.98 0.028
MCI[例(%)] 74(50.7) 51(34%) 0.005
受教育年限(年) 14.15±3.28 13.75±3.59 0.321
表3 MCI的Logistic回归分析
变量 B值 SE χ2值 OR值 95%CI P值
年龄 0.063 0.021 8.599 1.065 1.021～1.110 0.003
受教育年限 －0.189 0.042 19.859 0.828 0.762～0.900 <0.001
PPH 0.681 0.271 6.317 1.975 1.162～3.359 0.012
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