老年高血压合并脑出血患者轻度认知功能障碍发生现状及影响因素^*

The current situation and influencing factors of mild cognitive impairment in elderly patients with hypertension complicated with cerebral hemorrhage

摘要

目的 通过调查老年高血压合并脑出血患者继发轻度认知功能障碍(MCI)的发生率,探究其影响因素,为临床筛查和干预提供依据。方法 通过对106例老年高血压合并脑出血患者进行调查,收集患者相关资料,使用单因素分析、修正Poisson回归分析对老年高血压合并脑出血患者发生MCI的影响因素进行分析。结果 38例(35.85%)发生MCI,68例(64.15%)未发生MCI。单因素分析显示:两组的每日睡眠时间、每周运动时间、每周脑力活动时间、吸烟、饮酒、受教育程度、独居、社交活动、婚姻状况、肥胖、抑郁程度等比较,差异均有统计学意义(P＜0.05)。分组因素修正Poisson回归分析显示:饮酒、独居、肥胖、重度抑郁和丧偶是老年高血压合并脑出血患者继发MCI独立危险因素(P＜0.05);每日睡眠时间＞6 h、每周运动时间＞4 h、每周脑力活动时间＞4 h和每周至少参加1次社交活动是老年高血压合并脑出血患者继发MCI的保护因素(P＜0.05)。总体因素修正Poisson回归分析显示:每日睡眠时间＞6 h、每周运动时间＞4 h、每周脑力活动时间＞7 h、每周至少参加1次社交活动是老年高血压合并脑出血患者继发MCI的独立保护因素(P＜0.05),而饮酒是其独立危险因素(P＜0.05)。结论 老年高血压合并脑出血患者继发MCI发生率较高,应得到足够的重视,并采取增加睡眠时间、配合运动训练和脑力训练、积极参加社交活动等措施进行干预。

Abstract

Objective To investigate the incidence of mild cognitive impairment (MCI) in elderly patients with hypertension and cerebral hemorrhage, and to explore the influencing factors, providing a basis for clinical screening and intervention. Methods A total of 106 elderly patients with hypertension and cerebral hemorrhage were investigated. Relevant data of the patients was collected, and univariate and modified Poisson regression analyses were used to explore the influencing factors of MCI in elderly patients with hypertension and cerebral hemorrhage. Results MCI occurred in 38 cases (35.85%), while 68 cases did not develop MCI (64.15%). Univariate analysis showed statistically significant differences between the two groups in daily sleep duration, weekly exercise time, weekly mental activity time, smoking, alcohol consumption, education level, living alone, social activities, marital status, obesity, and depression severity (P＜0.05). Modified Poisson regression analysis for grouped factors showed that alcohol consumption, living alone, obesity, severe depression, and being widowed were independent risk factors for MCI secondary to intracerebral hemorrhage in elderly patients with hypertension (P＜0.05). Daily sleep duration＞6 h, weekly exercise time＞4 h, weekly mental activity time＞4 h, and participating in social activities at least once a week were protective factors for MCI secondary to intracerebral hemorrhage in elderly patients with hypertension (P＜0.05). Modified Poisson regression analysis for overall factors showed that daily sleep duration＞6 h, weekly exercise time＞4 h, weekly mental activity time＞7 h, and participating in social activities at least once a week were independent protective factors for MCI secondary to intracerebral hemorrhage in elderly patients with hypertension (P＜0.05), while alcohol consumption was an independent risk factor (P＜0.05). Conclusion The incidence of MCI in elderly patients with hypertension and cerebral hemorrhage is relatively high and should be given sufficient attention. Interventions such as increasing sleep time, combining exercise and mental training, and actively participating in social activities should be adopted.

关键词

轻度认知功能障碍 / 高血压 / 脑出血 / 影响因素

Key words

Mild cognitive impairment / Hypertension / Cerebral hemorrhage / Influencing factors

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基金资助

^*国家自然科学基金(72164003);自治区卫生健康委广西医疗卫生适宜技术(S2024100)