老老年轻度认知障碍与夜间舒张压负荷相关性研究

目的：探讨长期坚持降压治疗的老老年高血压病患者24 h动态血压参数与认知功能障碍之间的关系。方法对60例老老年高血压患者进行动态血压监测,并采用简易智能状态量表（MMSE）进行认知功能检查,根据 MMSE得分,将受试者分为轻度认知功能障碍组（27例）及正常组（33例）。所有受试者均进行24 h动态血压监测,比较血压参数及生化指标。结果轻度认知功能障碍组受教育年限为（4.29±5.38）年,低于认知功能正常组的（8.39±4.19）年,差异有统计学意义（P〈0.05）；轻度认知功能障碍组夜间舒张压负荷为（18.36±21.28）%,高于认知功能正常组的（4.04±8.75）%,差异有统计学意义（P〈0.05）。经Spearman相关性检验显示：受教育年限与认知能力呈正相关（r=0.541,P=0.003）；夜间舒张压负荷与认知能力呈负相关（r=-0.404,P=0.013）。结论对于长期坚持降压治疗的老老年高血压患者,受教育年限及认知及夜间舒张压升高与老老年认知功能关系密切,夜间舒张压升高可能是老老年认知功能障碍的一个危险因素,更好地控制夜间舒张压可能是防止老老年认知功能障碍的方法之一。

The Relations between Mild Impared Cognitive and Nocturnal Diastolic Blood Pressure Load in the Very Elderly with Hypertension

Objective To analyze the relations between cognitive dsyfunction and ambulatory blood pressure parameters in the long term adherence to antihypertensive treatment of the very elderly with hypertension.Methods Sixty very elderly patients with hypertension were observed by 24 h ambulatory blood pressure.The cognitive function were evaluated by mini mental state examina-tion.According to MMSE scores,the patients were divided into two groups：Mild impaired cognitive groups（n= 27）,normal cognitive function group（n= 33）.The blood pressure parameters and biochemical indicators were observed.Results The education years in mild impaired cognitive group was （4.29＆#177; 5.38）years,which was less than that in normal cognitive function group（8.39＆#177; 4.19） years,P〈0.05].The nocturnal diastolic blood pressure load was（18.36＆#177; 21.28）% in mild impared cognitive group,while was higher than that in normal cognitive function group （4.04＆#177; 8.75）%,P〈0.05].The Spearman correlation test showed that the education year and cognitive function was positively correlated （r= 0.543,P= 0.003）.The nocturnal diastolic blood pressure load exists signifi-cant negative correlation with cognitive function（r= -0.404,P= 0.013）.Conclusion To the long term adherence to antihyperten-sive treatment of the very elderly with hypertension,the education years and nocturnal diastolic blood pressure has close ties to mild impaired cognitive.The diastolic blood pressure at night may be a risk factor for cognitive dysfunction.The better control of nocturnal diastolic blood pressure may be one of the ways to prevent the elderly cognitive dysfunction.