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目的评估慢型克山病患者的认知功能状况及其相关影响因素。方法对符合《克山病诊断》标准的65例慢型克山病患者进行蒙特利尔认知评估量表(MoCA)认知功能评估,并选择62例病区健康人作为对照,收集受检人群的一般资料和临床资料,以患者认知状况为因变量,相关因素为自变量进行多元线性逐步回归分析。结果 (1)慢型克山病患者和病区健康人MoCA评分分别为(21.72±5.31)分与(24.39±4.47)分,两者比较差异有统计学意义(P<0.05);同时均低于标准界值26分,其中以延迟回忆、抽象力和视空间与执行功能受损最严重。(2)患者组不同心功能分级、患病时间及受教育年限的MoCA得分差异有显著统计学意义(P<0.01)。(3)多元线性逐步回归分析显示,心功能分级、受教育年限、病程及经济状况被纳入MoCA总分回归方程,F=26.554,P=0.000,决定系数(R2)=0.564,调整R2=0.543。结论慢型克山病患者认知功能受到不同程度的损害,NYHA心功能分级、受教育年限、病程及经济状况是相关影响因素,其中前两项是重要因素,应引起克山病防治工作者的高度重视。
Objective To evaluate the cognitive function of patients with chronic Keshan disease and its related factors. Methods Sixty-five patients with Kjeldahl disease who met the criteria of “diagnosis of Keshan disease” were assessed for cognitive function of Montreal Cognitive Assessment Scale (MoCA), and 62 healthy subjects were selected as controls to collect the subjects’ General information and clinical data, the patient’s cognitive status as the dependent variable, the relevant factors for the independent variable multiple linear stepwise regression analysis. Results (1) The MoCA scores of chronic Keshan disease and healthy people in the ward were (21.72 ± 5.31) and (24.39 ± 4.47) points, respectively, with significant difference between the two groups (P <0.05) In the standard threshold of 26 points, of which the delay in memory, abstraction and visual space and executive function most severely damaged. (2) There were significant differences in MoCA scores between the patients with different cardiac function grades, their duration of illness and their years of education (P <0.01). (3) Multivariate linear stepwise regression analysis showed that the classification of cardiac function, education years, course of disease and economic status were included in MoCA score regression equation, F = 26.554, P = 0.000, R2 = 0.564 and R2 = 0.543 . Conclusions The cognitive function of patients with chronic Keshan disease was impaired to varying degrees. The classification of NYHA functional class, years of education, course of disease and economic status were related factors, of which the first two were important factors that should cause Keshan disease prevention and treatment workers The height of attention.