摘要
慢性阻塞性肺疾病(COPD)除了累及肺部外,还经常引起全身不良反应,可损害中枢神经系统,导致认知功能障碍,影响患者自我照护能力和日常生活能力,从而影响COPD患者的预后。本文对国内外COPD患者出现认知障碍相关因素的研究及进展进行了全面的归纳和总结,其中年龄、文化程度、吸烟、COPD严重程度及病程、机械通气时间、反复拔管失败、高碳酸血症、冠心病、高血压、呼吸衰竭、肺部感染及炎症、动脉硬化、精神心理因素、营养不良等均为危险因素;BODE指数和6分钟步行距离的提高、高尿酸水平、肝素雾化吸入和多奈哌齐治疗、适度运动等为保护因素;低氧血症、大脑内部结构改变、认知功能训练、长期氧疗、睡眠等仍存在争议,没有统一的结论;组氨酸补充剂、室内空气污染由于相关研究少,为可能相关的因素,需要进一步探究。因此,医务工作者应及时识别相关因素并尽早地进行干预,这对预防或延缓认知障碍的发生、发展,降低认知功能损害和提高COPD治疗疗效有着重要意义。
Chronic obstructive pulmonary disease(COPD),in addition to lung involvement,often causes systemic adverse effects,which can damage the central nervous system,leading to cognitive dysfunction,affecting patients’ability to self-care and daily living,and thus affecting the prognosis of COPD patients.In this paper,the related factors of cognitive impairment in patients with COPD at home and abroad are summarized and development,including age,culture level,smoking,COPD severity and duration,mechanical ventilation time and extubation failure repeatedly,hypercapnia,coronary heart disease,high blood pressure,respiratory failure,lung infection and inflammation,atherosclerosis,mental psychological factors and malnutrition are all risk factors;The increase of BODE index and 6 min walking distance,high uric acid levels,heparin aerosol inhalation and donepezil treatment,moderate exercise are protective factors;Hypoxemia,internal structure change in brain,cognitive function training,long-term oxygen therapy,sleep are still controversial,and there is no unified conclusion.Histidine supplement and indoor air pollution are possible related factors due to the lack of relevant studies,which need further investigation.Therefore,medical workers should identify relevant factors in time and intervene as early as possible,which is of great significance to prevent or delay the occurrence and development of cognitive dysfunction,reduce cognitive impairment and improve the treatment efficacy of COPD.
作者
窦宇琪
冯皓然
邹言佳
陈泽琨
于雪
王岚
马德福
Haoran;ZOU Yanjia;CHEN Zekun;YU Xue;WANG Lan;MA Defu(Peking University,Beijing 100191,China;Harbin Medical University,Harbin 150081,China;Beijing United Family Hospital,Beijing 100032,China)
出处
《中国全科医学》
CAS
北大核心
2021年第S02期1-7,共7页
Chinese General Practice
基金
国家自然科学基金青年基金资助项目(71804125)
关键词
肺疾病
慢性阻塞性
慢性阻塞性肺疾病
认知功能障碍
相关因素
Pulmonary disease,chronic obstructive
Chronic obstructive pulmonary disease
Cognitive dysfunction
Related factors
