老年高血压患者认知障碍与动态血压的关系分析

目的　分析老年高血压患者认知功能障碍与动态血压的关系。方法　对 117例老年高血压患者进行动态血压检测 ,并采用微型智能量表 (mini- mental state examination,MMSE)评定认知功能。结果　在控制年龄、性别和教育程度的影响之后 ,除 2 4 h平均舒张压之外 ,其他动态血压指标均与认知功能 (以 MMSE得分的对数 Ig MMSE表示 )显著负相关 ,尤其 2 4 h平均收缩压、日间平均收缩压、日间收缩压血压负荷、夜间舒张压血压负荷与认知功能呈更明显的负相关。以 Ig MMSE作为因变量 ,进行多元逐步回归分析 ,仅日间平均收缩压和年龄被纳入回归方程。“杓型”高血压患者的 MMSE得分显著高于“非杓型”者。结论　收缩压尤其是日间平均收缩压升高和血压节律紊乱是影响老年认知功能的重要因素

Study on Relationship between Cognitive Impairment and Dynamic Blood Pressure in the Elderly Patients with Hypertension

Objective To analyse the relationship between cognitive impairment and dynamic blood pressure in the elderly patients with hypertension.Methods Blood pressures of 117 elderly patients with hypertension were observed dynamically and mini mental state examination(MMSE) was used to evaluate their cognitive function.Results Except for average 24 hour diastolic blood pressure(DBP),cognitive function(represented by logarithmic MMSE,IgMMSE) showed significant negative correlation to the other indices in dynamic blood pressure monitoring,particularly to the average 24 hour systolic blood pressure(SBP),average daytime SBP,load degree of daytime SBP and load degree of nighttime DBP,after being adjusted for age,gender,and education.In the multivariate stepwise regression analysis,only the average daytime SBP and age entered the equation with IgMMSE as dependent.MMSE scores in the dippers were significantly higher than those in the nondippers.Conclusion Elevated SBP,especially elevated average daytime SBP and abnormal circadian rhythm of blood pressure were important influencing factors of poor cognitive function in the elderly.