老年高血压病患者认知功能与血栓前状态的相关性研究

目的 探讨老年高血压病患者认知功能与血栓前状态的关系。方法 收集到我院就诊的163例老年高血压病患者,根据国际通用的简易智力状况量表得分进行认知功能评定。将患者分为2组：认知功能障碍组作为病例组41例,认知功能正常组作为对照组122例。按统一方法测量血压、身高、体重等,收集空腹静脉血,测定血脂,血糖,纤维蛋白原（Fib）,血管性血友病因子（vWF）,纤溶酶原激活物抑制物-1（PAI-1）及血浆!-颗粒膜蛋白（GMP-140）等。结果 文化程度、饮酒史、年龄、舒张压、Fib、GMP-140、vWF及PAI-1及在老年高血压病患者认知功能正常组和认知功能障碍组之间的差异有统计学意义（P〈0.05）。Logistic回归分析显示：年龄、文化程度、Fib、vWF及PAI-1与认知功能成正相关（OR值分别为1.112,12.346,1.368,1.107,2.303,P〈0.05）,舒张压与认知功能成负相关（OR值为0.631）。结论 老年高血压病患者认知功能损害除与舒张压、年龄、文化程度相关外,还与血栓前状态分子标志物Fib、vWF及PAI-1相关,这说明血栓前状态可能是老年高血压病患者认知功能障碍重要的危险因素。

Study on Relationship between Cognition and Prothrombotic State in Elderly Hypertensive Patients

Objective To explore the relationship between cognition and prothrombotic state in elderly hypertensive patients. Methods 163 elderly hypertensive patients were included. We used the Mini Mental State Examination to test the cognitive function and calculate scores. Primary hypertensive patients were divided into two groups：the patients with impaired cognition were classified as case group（n=41）, the patients with normal cognition as control group（n=122）. Blood pressure, height and body weight were recorded. Total cholesterol, triglyceride, fibrinogen,vWF,GMP-140 and PAI-1level were measured. Results Univariate analysis showed that significant difference were found in age, educational level, diastolic pressure,history of alcohol drinking, Fib, Vwf,GMP-140 and PAI-1 between normal cognition function group and impaired cognition function group（P〈0. 05）. Multivariate logistic regression analysis in 163 elderly patients showed that age（OR=1. 112,P〈0. 05）,DBP（OR=0. 631,P〈0. 05）, Educational level（OR=12. 35,P〈0. 05）,Fib（OR=1. 368,P〈0. 05）,vWF（OR=1. 107,P〈0. 05）and PAI-1（OR=2. 303,, P〈0. 05）were correlated to cognitive impairment. Conclusion Besides Diastolic blood pressure,age and educational level, Fib, vWF and PAI-1 are associated with cognitive impairment. Prothrombotic state may be an independent risk factor of cognitive deterio-ration in elderly hypertensive patients.