CAJ | 학술논문

目的：探讨COPD患者是否存在认知损害，同时在COPD患者中研究疾病的严重性对认识损害的影响，以及家庭氧疗对减轻患者认知损害带来的潜在益处。方法选择稳定期80例C O PD患者，同时选择健康居民80例作为对照组，采用简易精神状态法（Mini‐Mental State Exam ，MMSE）测定2组的认知功能，COPD的严重程度由患者的血氧饱和度及肺功能，特别是FEV1决定，利用统计学方法测定是否COPD的严重程度与认知损害的发生有关，同时调查COPD组患者家庭氧疗后认知损害有无明显减轻。结果 COPD组MMSE总分及定向力、记忆力、计算力和注意力、回忆力和语言能力等五项分测验评分明显低于对照组。血氧饱和度的降低与认知损害的发生差异有统计学意义（χ2＝0．23， P ＜0．05）。相应地，规律的家庭氧疗能明显降低认知损害的发生（χ2＝0．09，P ＜0．001）。结论 COPD是认知损害发生的高危因素，认知功能损害与低氧血症程度相关。长期家庭氧疗能明显减轻患者认知损害带来的潜在益处，从而延长COPD患者生命及提高生活质量。
목적：탐토COPD환자시부존재인지손해，동시재COPD환자중연구질병적엄중성대인식손해적영향，이급가정양료대감경환자인지손해대래적잠재익처。방법선택은정기80례C O PD환자，동시선택건강거민80례작위대조조，채용간역정신상태법（Mini‐Mental State Exam ，MMSE）측정2조적인지공능，COPD적엄중정도유환자적혈양포화도급폐공능，특별시FEV1결정，이용통계학방법측정시부COPD적엄중정도여인지손해적발생유관，동시조사COPD조환자가정양료후인지손해유무명현감경。결과 COPD조MMSE총분급정향력、기억력、계산력화주의력、회억력화어언능력등오항분측험평분명현저우대조조。혈양포화도적강저여인지손해적발생차이유통계학의의（χ2＝0．23， P ＜0．05）。상응지，규률적가정양료능명현강저인지손해적발생（χ2＝0．09，P ＜0．001）。결론 COPD시인지손해발생적고위인소，인지공능손해여저양혈증정도상관。장기가정양료능명현감경환자인지손해대래적잠재익처，종이연장COPD환자생명급제고생활질량。
Objective This study aimed to elucidate the association between chronic obstructive pulmonary disease (COPD) and the risk of cognitive impairment compared to referent subjects without COPD .In patients with established COPD ,we evaluated the impact of disease severity and impairment of respiratory physiology on cognitive impairment and the potential mitigating role of oxygen therapy . Methods We used the cohort study of adults with COPD ( n=80) and referent subjects matched by age , sex ( n = 80) to study the potential risk factors for cognitive impairment among subjects with COPD . Cognitive impairment was defined as a Mini‐Mental State Exam score of ,24 points .Disease severity was using forced expiratory volume in one second and SpO2 .Multivariable analysis was used to control for confounding by age ,sex ,educational attainment ,and cigarette smoking .Results COPD was associated with a substantive risk of cognitive impairment compared to referent subjects .Low baseline oxygen saturation was related to increased risk of cognitive impairment (χ2 = 0 .23 ,P < 0 .05) .Conversely , regular use of supplemental oxygen therapy decreased the risk for cognitive impairment (χ2=0 .09 ,P<0 .001) .Conclusions COPD is a major risk factor for cognitive impairment .Among patients with COPD , hypoxemia is a major contributor and regular use of home oxygen is protective .Health care providers should consider screening their COPD patients for cognitive impairment .