伴代谢异常的高血压患者认知功能评价

目的评价伴代谢异常高血压患者的认知功能。方法入选原发性高血压(EH)患者85例和伴代谢异常原发性高血压(EH+MD)患者74例,高血压病程均>5年。运用《临床记忆量表手册》和《CISA中国成人智力量表》进行记忆、智能测定。1)评价两组认知功能;2)在EH+MD组中按照合并糖、脂代谢异常进行分组:合并糖代谢异常组(27例),合并脂代谢异常组(15例),同时合并糖脂代谢异常组(32例),比较3组间认知功能改变。结果在EH和EH+MD两组间比较:EH组在指向记忆,联想学习和图像自由回忆,人像特点联系回忆等反应短期记忆功能指标均明显优于EH+MD组(P均<0.05);在数字背诵能力、注意分辨因素等智能指标:EH组明显优于EH+MD组(P均<0.01)。回归分析证明EH组与EH+MD组收缩压与记忆商(MQ)之间呈负相关(P=0.001);在联想学习、图像自由回忆,人像特点联系回忆量表分数:合并糖脂代谢异常组成绩最低(P<0.01),合并脂代谢异常组成绩最高(P<0.01);数字背诵量表分、注意分辨等智能指标:发现合并糖代谢异常组成绩最低(P<0.01),合并脂代谢异常最高(P<0.01)。结论与EH相比,EH+MD组患者有明显认知功能下降。尤其在伴糖代谢异常、和同时合并糖脂代谢异常患者,日常生活能力下降。提示糖代谢异常在导致认知功能下降中起到重要作用。

Cognitive Function in Hypertension Patients Complicated with Metabolism Diseases

Objective To Evaluate the cognitive function in essential hypertensive patients complicated with metabolism diseases. Methods Eighty five essential hypertensive patients(EH)and other seventy four essential hypertensive patients complicated with metabolic disorder (EH+MD) were enrolled. Patients of EH+MD were categorized into glucose metabolism disorder (n=27), hyperlipidemia (n=15) and gluco-lipid metabolism disorder (n=22). Cognitive function was evaluated using "Clinical memory measuring scale" and "CISA intelligence scale". Results Direction and association memory, free imaging and portrait memory were better in EH than that in EH+MD (P<0.05), while recting number ability and attention, distinguish ability were significantly superior in EH (P<0.01). Regression analysis revealed negative correlation between SBP and memory quotient (MQ) which was declined markedly in patients with EH+MD with the increases in SBP. Patients with glucose metabolism disorder had the lowest score in association test, free imaging, protrait memory index, other as well as reciting number ability, attention, and distinguish ability, compared with highest scores earned by the patients of hyperlipidemia ( P<0.01). Conclusion More severe cognitive impairments were shown in patients with essential hypertension complicated with metabolism disorders than that of essential hypertension alone. Glucose meta-bolism disorder seems to be the worst culprit for the deterioation of cognitive function.