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目的探讨老年高血压患者认知功能障碍的影响因素。方法使用简易精神状态量表(mini-mental state examination,MMSE)及蒙特利尔认知评价量表(Montreal cognitive assessment,Mo CA)评估老年高血压患者的认知功能,根据量表得分将老年高血压患者分为认知功能正常组与认知功能障碍组,比较两组之间的血糖水平、血清胰岛素水平、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(methane dicarboxylic aldehyde,MDA)水平。结果老年高血压患者中,与认知功能正常组相比,认知功能障碍组平均年龄较大[(75.48±8.89)岁、vs.(70.74±7.68)岁,P=0.003],差异有显著的统计学意义。两组之间的性别比例,认知功能障碍组与认知功能正常组男性所占比例为(50.00%vs 68.08%,P=0.045),差异有统计学意义。老年高血压患者认知功能的异常主要表现在视空间与执行能力、命名能力、延迟记忆力和定向力4个方面。与认知功能正常组相比,老年高血压患者认知功能障碍组SOD水平较高[(58.76±23.50)vs.(36.09±20.01)U/ml],差异有统计学意义(P=0.004)。IR较高[5.18(2.67-8.59)vs 6.45(4.31-10.83)],差异有统计学意义(P=0.045)。结论高龄、女性老年高血压患者更易发生认知功能障碍,认知损害主要在视空间与执行功能,命名能力、延迟记忆力与定向力方面。老年高血压患者中认知功能障碍组有较高的氧化应激水平和胰岛素抵抗。
Objective To explore the influencing factors of cognitive dysfunction in elderly patients with hypertension. Methods MMSE and MoCA were used to evaluate the cognitive function of elderly hypertensive patients. According to the scale score, the elderly hypertensive patients The subjects were divided into normal cognitive function group and cognitive dysfunction group. The levels of blood glucose, serum insulin, superoxide dismutase (SOD), and the levels of methane dicarboxylic aldehyde (MDA) . Results Compared with normal cognitive function group, the average age of cognitive dysfunction group was significantly higher in elderly hypertensive patients (75.48 ± 8.89 years vs 70.74 ± 7.68 years, P = 0.003) The statistical significance. The proportion of gender between the two groups, cognitive dysfunction group and normal cognitive function group of men (50.00% vs 68.08%, P = 0.045), the difference was statistically significant. Cognitive dysfunction in elderly patients with hypertension mainly in the visual space and executive ability, naming ability, delayed memory and orientation of four aspects. Compared with normal cognitive function group, the level of SOD in elderly patients with hypertension was higher than that in normal group [(58.76 ± 23.50) vs. (36.09 ± 20.01) U / ml], the difference was statistically significant (P = 0.004) . IR higher [5.18 (2.67-8.59) vs 6.45 (4.31-10.83)], the difference was statistically significant (P = 0.045). Conclusion Elderly hypertensive patients are more likely to have cognitive dysfunction. Cognitive impairment mainly depends on visual space, executive function, naming ability, delayed memory and orientation. Cognitive impairment in elderly hypertensive patients with higher levels of oxidative stress and insulin resistance.