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目的探讨充血性心力衰竭(CHF)认知障碍的特点以及血压对其影响。方法对2010年1月至2011年12月在中国医科大学附属盛京医院住院的80例CHF患者以及50例非CHF的心脏病(no-CHF)患者进行蒙特利尔认知评估量表(MOCA)评估,比较两组认知障碍发生率及其特点,并分析相关危险因素。同时观察血压对CHF患者认知障碍的影响。结果 (1)58.8%CHF组患者有认知障碍,而no-CHF组是20%(P<0.01)。(2)CHF患者Mo CA评分明显低于对照组(P<0.05),主要表现在视空间与执行功能、注意力、语言、抽象和延迟回忆等方面。(3)冠心病、高血压病、糖尿病、慢性阻塞性肺疾病、收缩压(SBP)及舒张压(DBP)是其独立危险因素。(4)有认知障碍的CHF患者血压与no-CHF组比较显著降低(P<0.05)。结论 CHF患者存在不同程度的认知障碍,冠心病、高血压病、糖尿病和慢性阻塞性肺疾病、SBP、DBP是其独立危险因素。低血压与老年CHF患者认知障碍确切相关。
Objective To investigate the characteristics of cognitive impairment in congestive heart failure (CHF) and its influence on blood pressure. Methods Montréal Cognitive Assessment Scale (MOCA) was evaluated in 80 CHF patients hospitalized at Shengjing Hospital affiliated to China Medical University from January 2010 to December 2011 and 50 patients with non-CHF heart disease (no-CHF) The incidence of cognitive impairment and its characteristics were compared between the two groups, and the related risk factors were analyzed. At the same time observe the impact of blood pressure on cognitive impairment in CHF patients. Results (1) 58.8% CHF patients had cognitive impairment, compared with 20% in the no-CHF group (P <0.01). (2) The Mo CA score of CHF patients was significantly lower than that of the control group (P <0.05), mainly in visual space and executive function, attention, language, abstraction and delayed recall. (3) Coronary heart disease, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, systolic blood pressure (SBP) and diastolic blood pressure (DBP) are independent risk factors. (4) The blood pressure of CHF patients with cognitive impairment was significantly lower than that of no-CHF group (P <0.05). Conclusion CHF patients have different degrees of cognitive impairment, coronary heart disease, hypertension, diabetes and chronic obstructive pulmonary disease, SBP and DBP are independent risk factors. Hypotension is associated with cognitive impairment in elderly patients with CHF.