中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2014年
10期
769-773
,共5页
肺疾病,阻塞性%认知功能%蒙特利尔认知评估
肺疾病,阻塞性%認知功能%矇特利爾認知評估
폐질병,조새성%인지공능%몽특리이인지평고
Pulmonary disease,obstructive%Cognition%Montreal cognitive assessment
目的 探讨并分析稳定期慢性阻塞性肺疾病(简称慢阻肺)患者的认知功能及其影响因素.方法 连续选择2012年12月至2013年12月天津市胸科医院门诊就诊的稳定期慢阻肺患者,采用蒙特利尔认知评估(MoCA)方法观察稳定期慢阻肺患者与健康对照人群的认知功能差异,并观察慢阻肺全球创议(GOLD)分级(GOLD Ⅰ级、GOLDⅡ级、GOLDⅢ级、GOLDⅣ级)、PaO2及PaCO2对认知功能的影响.结果 慢阻肺组MoCA评分为20.6±2.3,对照组MoCA评分为25.3±1.7,前者低于后者,差异有统计学意义(P＜0.01).GOLD Ⅰ级组、GOLDⅡ级组、GOLDⅢ级组及GOLDⅣ级组MoCA评分比较差异有统计学(F=31.69,P＜0.05),其中GOLD Ⅰ级组MoCA评分(22.4±0.8)高于GOLDⅡ级组(21.7±1.0),但差异无统计学意义(P＞0.05);GOLDⅡ级组MoCA评分高于GOLDⅢ级组(20.2±1.2),差异有统计学意义(P＜0.05);GOLDⅢ级组MoCA评分高于GOLDⅣ级组(19.1±1.2),差异有统计学意义(P＜0.05).PaO2≥60 mmHg(1 mmHg=0.133 kPa)组的MoCA评分(22.2±1.1)高于PaO2＜ 60 mmHg组(19.8±1.1),差异有统计学意义(P＜0.05);PaCO2 ≥50 mmHg组的MoCA评分(20.0±1.3)低于PaCO2＜ 50 mmHg组(22.3±1.0),差异有统计学意义(P＜0.05).回归分析结果显示,年龄(标准化回归系数为-0.146)、受教育程度(标准化回归系数为0.134)、GOLD分级(标准化回归系数为0.351)、PaO2(标准化回归系数为0.305)及PaCO2(标准化回归系数为-0.145)是影响慢阻肺患者认知功能的主要因素(均P＜0.01).结论 稳定期慢阻肺患者的MoCA评分低于正常人群;GOLD分级越差,MoCA评分越低;伴有低氧血症的稳定期慢阻肺患者的MoCA评分低于非低氧血症患者;伴有高碳酸血症患者的MoCA评分低于非高碳酸血症患者;慢阻肺患者认知功能的主要影响因素是年龄、受教育程度、GOLD分级、PaO2及PaCO2.
目的 探討併分析穩定期慢性阻塞性肺疾病(簡稱慢阻肺)患者的認知功能及其影響因素.方法 連續選擇2012年12月至2013年12月天津市胸科醫院門診就診的穩定期慢阻肺患者,採用矇特利爾認知評估(MoCA)方法觀察穩定期慢阻肺患者與健康對照人群的認知功能差異,併觀察慢阻肺全毬創議(GOLD)分級(GOLD Ⅰ級、GOLDⅡ級、GOLDⅢ級、GOLDⅣ級)、PaO2及PaCO2對認知功能的影響.結果 慢阻肺組MoCA評分為20.6±2.3,對照組MoCA評分為25.3±1.7,前者低于後者,差異有統計學意義(P＜0.01).GOLD Ⅰ級組、GOLDⅡ級組、GOLDⅢ級組及GOLDⅣ級組MoCA評分比較差異有統計學(F=31.69,P＜0.05),其中GOLD Ⅰ級組MoCA評分(22.4±0.8)高于GOLDⅡ級組(21.7±1.0),但差異無統計學意義(P＞0.05);GOLDⅡ級組MoCA評分高于GOLDⅢ級組(20.2±1.2),差異有統計學意義(P＜0.05);GOLDⅢ級組MoCA評分高于GOLDⅣ級組(19.1±1.2),差異有統計學意義(P＜0.05).PaO2≥60 mmHg(1 mmHg=0.133 kPa)組的MoCA評分(22.2±1.1)高于PaO2＜ 60 mmHg組(19.8±1.1),差異有統計學意義(P＜0.05);PaCO2 ≥50 mmHg組的MoCA評分(20.0±1.3)低于PaCO2＜ 50 mmHg組(22.3±1.0),差異有統計學意義(P＜0.05).迴歸分析結果顯示,年齡(標準化迴歸繫數為-0.146)、受教育程度(標準化迴歸繫數為0.134)、GOLD分級(標準化迴歸繫數為0.351)、PaO2(標準化迴歸繫數為0.305)及PaCO2(標準化迴歸繫數為-0.145)是影響慢阻肺患者認知功能的主要因素(均P＜0.01).結論 穩定期慢阻肺患者的MoCA評分低于正常人群;GOLD分級越差,MoCA評分越低;伴有低氧血癥的穩定期慢阻肺患者的MoCA評分低于非低氧血癥患者;伴有高碳痠血癥患者的MoCA評分低于非高碳痠血癥患者;慢阻肺患者認知功能的主要影響因素是年齡、受教育程度、GOLD分級、PaO2及PaCO2.
목적 탐토병분석은정기만성조새성폐질병(간칭만조폐)환자적인지공능급기영향인소.방법 련속선택2012년12월지2013년12월천진시흉과의원문진취진적은정기만조폐환자,채용몽특리이인지평고(MoCA)방법관찰은정기만조폐환자여건강대조인군적인지공능차이,병관찰만조폐전구창의(GOLD)분급(GOLD Ⅰ급、GOLDⅡ급、GOLDⅢ급、GOLDⅣ급)、PaO2급PaCO2대인지공능적영향.결과 만조폐조MoCA평분위20.6±2.3,대조조MoCA평분위25.3±1.7,전자저우후자,차이유통계학의의(P＜0.01).GOLD Ⅰ급조、GOLDⅡ급조、GOLDⅢ급조급GOLDⅣ급조MoCA평분비교차이유통계학(F=31.69,P＜0.05),기중GOLD Ⅰ급조MoCA평분(22.4±0.8)고우GOLDⅡ급조(21.7±1.0),단차이무통계학의의(P＞0.05);GOLDⅡ급조MoCA평분고우GOLDⅢ급조(20.2±1.2),차이유통계학의의(P＜0.05);GOLDⅢ급조MoCA평분고우GOLDⅣ급조(19.1±1.2),차이유통계학의의(P＜0.05).PaO2≥60 mmHg(1 mmHg=0.133 kPa)조적MoCA평분(22.2±1.1)고우PaO2＜ 60 mmHg조(19.8±1.1),차이유통계학의의(P＜0.05);PaCO2 ≥50 mmHg조적MoCA평분(20.0±1.3)저우PaCO2＜ 50 mmHg조(22.3±1.0),차이유통계학의의(P＜0.05).회귀분석결과현시,년령(표준화회귀계수위-0.146)、수교육정도(표준화회귀계수위0.134)、GOLD분급(표준화회귀계수위0.351)、PaO2(표준화회귀계수위0.305)급PaCO2(표준화회귀계수위-0.145)시영향만조폐환자인지공능적주요인소(균P＜0.01).결론 은정기만조폐환자적MoCA평분저우정상인군;GOLD분급월차,MoCA평분월저;반유저양혈증적은정기만조폐환자적MoCA평분저우비저양혈증환자;반유고탄산혈증환자적MoCA평분저우비고탄산혈증환자;만조폐환자인지공능적주요영향인소시년령、수교육정도、GOLD분급、PaO2급PaCO2.
Objective To explore and analyze the cognitive function in patients with stable chronic obstructive pulmonary disease (COPD).Methods The cognition differences between patients with COPD and healthy subjects were analyzed by Montreal Cognitive Assessment (MoCA).GOLD grade,PaO2,PaCO2,the education degree and the age were included as associated factors.The correlation between those factors with cognition were analyzed.Results The MoCA in patients with COPD was 20.6 ± 2.3,and that in healthy subjects was 25.3 ± 1.7 ; the difference between the 2 groups being significant (P ＜ 0.01).The MoCA was 22.4 ± 0.8 in patients with GOLD grade Ⅰ disease,21.7 ± 1.0 in grade Ⅱ,20.2 ± 1.2 in grade Ⅲ,and 19.1 ± 1.20 in grade Ⅳ diseases; the difference among the 4 subgroups being significant (F=31.69,P＜0.05).The MoCA in GOLD grade Ⅰ was higher than that in GOLD grade Ⅱ,but the difference did not reach significance (P ＞ 0.05).The MoCA of GOLD grade Ⅱ was higher than that in GOLD grade Ⅲ (P ＜ 0.05),and the MoCA of GOLD grade Ⅲ was higher than that GOLD grade Ⅳ (P ＜ 0.05).The MoCA in non-hypoxemia subgroup and hypoxemia subgroup was 22.2 ± 1.1 and 19.8 ± 1.1,respectively(P ＜ 0.05),while the MoCA in hypercapnia subgroup and non-hypercapnia subgroup was 20.0 ± 1.3 and 22.3 ± 1.0 respectively (P ＜ 0.05).By regression analysis,the score of MoCA was correlated positively to education degree (Standard B1 =0.134,P ＜ 0.01),GOLD grade (Standard B2 =0.351,P ＜ 0.01) and PaO2 (Standard B3 =0.305,P ＜ 0.01),while the score of MoCA was correlated negatively to age(Standard B4 =-0.146,P ＜ 0.01) and PaCO2 (Standard B5 =-0.145,P ＜ 0.01).Conclusions The MoCA score in patients with COPD was lower than that in healthy people.Lower MoCA score was found in patients with severe COPD.The MoCA scores in both hypoxemia subgroup and hypercapnia subgroup were lower.The cognitive dysfunction in patients with stable COPD was positively correlated with education degree,GOLD grade,and PaO2,but negatively with age and PaCO2.
