CAJ | 학술논문

目的探讨稳定期慢性阻塞性肺疾病(COPD)患者的注意功能及其损害的具体机制.方法选取2011年2—9月在安徽医科大学第一附属医院呼吸内科确诊的稳定期COPD患者38例(男30例,女8例,年龄51～ 75岁),与其年龄、教育程度相匹配的健康对照者36名(男22名,女14名,年龄47～79岁),应用注意网络测试,对其注意功能进行神经心理学对比分析.结果 COPD组和对照组的定向网络效率分别为(27±8)和(57±4)ms,差异有统计学意义(P =0.001).COPD组的警觉网络、执行控制网络效率分别为(19±7)和(94±15) ms,低于对照组的(32±4)和(119±11)ms,但差异均无统计学意义(P值分别为0.115和0.196).COPD组注意网络检查正确率为90.2％±1.6％,低于对照组的96.3％±1.7％,差异有统计学意义(P=0.011).COPD组和对照组词汇流畅性测试结果分别为(18.2±0.5)和(21.4±0.6)分,差异有统计学意义(P =0.000).结论稳定期COPD患者存在注意功能受损,其中定向功能受损最为显著.这可能与COPD患者长期慢性缺氧及缺氧相关的颞、顶部血流低灌注,或抗胆碱能药物应用有关.
목적 탐토은정기만성조새성폐질병(COPD)환자적주의공능급기손해적구체궤제.방법 선취2011년2—9월재안휘의과대학제일부속의원호흡내과학진적은정기COPD환자38례(남30례,녀8례,년령51～ 75세),여기년령、교육정도상필배적건강대조자36명(남22명,녀14명,년령47～79세),응용주의망락측시,대기주의공능진행신경심이학대비분석.결과 COPD조화대조조적정향망락효솔분별위(27±8)화(57±4)ms,차이유통계학의의(P =0.001).COPD조적경각망락、집행공제망락효솔분별위(19±7)화(94±15) ms,저우대조조적(32±4)화(119±11)ms,단차이균무통계학의의(P치분별위0.115화0.196).COPD조주의망락검사정학솔위90.2％±1.6％,저우대조조적96.3％±1.7％,차이유통계학의의(P=0.011).COPD조화대조조사회류창성측시결과분별위(18.2±0.5)화(21.4±0.6)분,차이유통계학의의(P =0.000).결론 은정기COPD환자존재주의공능수손,기중정향공능수손최위현저.저가능여COPD환자장기만성결양급결양상관적섭、정부혈류저관주,혹항담감능약물응용유관.
Objective To explore the influences of stable chronic obstructive pulmonary disease (COPD) on attention functions.Methods The research objects came from the Hospital Affiliated to Anhui Medical University from Februray to September in 2011.Attention network test (ANT) was employed to compare stable COPD patients ( n =38) with healthy controls ( n =36) in the efficiencies of anatomically defined attentional networks:alertness,orientation and executive attention.Results Significant group differences were found in orientation ( ( 27 ± 8 ) ms vs ( 57 ± 4 ) ms,P =0.001 ),but not in alertness ( ( 19 ± 7) ms vs (32 ± 4) ms,P =0.115) or executive attention network ( (94 ± 15) ms vs ( 119 ± 11 ) ms,P =0.196).The accuracy of attention network test was significantly slower in the COPD group than in the healthy controls (90.2％ ± 1.6％ vs 96.3％ ± 1.7％,P =0.011 ).The score of verbal fluency test was significantly lower in COPD patients than in healthy controls (18.2 ± 0.5 vs 21.4 ± 0.6,P =0.000).Conclusions The attention functions of COPD patients are impaired,especially oriental network efficiency.It is probably due to chronic hypoxia,hypoxia-related low blood flow of temporal or parietal lobe or long-term anticholinergic drug use.