摘要
目的:探讨稳定期慢性阻塞性肺疾病tients with COPD(chronic obstructive pulmonary disease,COPD)患者的认知功能,明确其认知功能的变化及认知功能损害的相关因素。方法:选择稳定期COPD患者37例进行血气参数及肺功能测定,选择同期北京市城区健康居民40例为对照组,两组年龄、性别及受教育程度无显著性差异(P>0.05),均采用扩充痴呆量表(Expansive Scale of Dementia,ESD)进行认知功能评价。根据动脉血氧分压值(PaO2)及FEV1占预测值百分比将患者分组。结果:COPD组ESD总分及学习、记忆、计算、结构等四项分测验评分均明显低于对照组(总平均分相差16分,208.1±17.6/224.3±10.6,t=5.19,P<0.001,四项分测验均值相差3-5分,差异均有统计学意义)。PaO2<60mmHgCOPD组ESD总分及学习、记忆力和计算力等三项分测验评分明显低于PaO2≥60mmHgCOPD组(总平均分相差12分,199.4±12.1/211.8±18.4,t=2.05,P=0.048,其他分测验也相差2-5分,其中学习项相差最多22.9±6.8/18.0±2.3,t=2.35,P=0.025)。FEV1占预测值百分比<50%COPD组与FEV1占预测值百分比≥50%COPD组ESD总分分别为205.7±18.1及211.5±16.7,两组评分差异无统计学意义。回归分析显示,PaO2及受教育程度与影响COPD患者ESD评分,两者的标化回归系数分别为0.425和0.245(均P<0.01)。结论:稳定期COPD患者ESD评分明显低于正常对照组,主要表现在学习、记忆、计算、结构等方面。ESD评分主要影响因素为受教育程度及PaO。
Objective： To evaluate cognitive changes of stable patients with chronic obstructive pulmonary disease （ COPD ） by the Expansive Scale of Dementia （ ESD ） , and the factors affecting them. Methods： 37 patients with stable COPD were investigated in our study, 40 healthy persons as control, there was no significant difference in age, sex and education degree between patients with COPD and controls （ P 〉 0.05 ） . The blood gas analysis （ BGA ） and pulmonary function test （ PFT） were performed in patients with stable COPD. The cognitive function was evaluated by ESD in both patients with stable COPD and healthy persons as control. The patients were divided into different groups by BGA and PFT （ FEV1/Pred ） . Results： The total score of ESD and the subtest scores of ESD in leaning , memory , calculation , constructive function were obviously lower in the patient group than those in the control group （The mean difference of the total score was 16, with the two groups＇total scores as 208. 1 ± 17. 6/224.3 ± 10. 6, t = 5. 19, P 〈 0. 001, the mean differences of the four subtest varied from 3 to 5 ） . The total score of ESD and the subtest scores of ESD in learning , memory , calculation were obviously lower in group B （ PaO2 〈 60 mmHg ） than those in group A （ PaO2 ≥60 mmHg ） （ The mean difference of the total score was 12, 199. 4 ± 12. 1/211.8 ± 18.4, t = 2. 05, P = 0. 048, the mean differences of the three subtests varied from 2 to 5, the most significant one was the that of learning, 22. 9 ± 6. 8/18.0 ± 2. 3, t = 2.35, P = 0. 025 ） . The total score of ESD were 211.5 ± 16. 7 in group A （ FEV1/ Pred≥50% ） and 205.7 ± 18. 1 in group B （ FEV1/Pred 〈50% ） , this difference was not significant in statistic. By regression analysis, the total score of ESD （ Y ） was positively correlate to PaO2 （ X1 ） and education degree （ X2 ） , Standard B1（PaO2） =0.425 （P〈0.01）, Standard B2 （education） =0.245 （P〈0.01） . Conclusion： There is cognitive dysfunction in stable patients with COPD, especially in leaning, memory, calculation and constructive function. The cognitive dysfunction in stable patients with COPD has positive correlation with hypoxia and education degree.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2008年第1期32-36,共5页
Chinese Mental Health Journal
关键词
慢性阻塞性肺疾病
认知功能
扩充痴呆量表
chronic obstructive pulmonary disease （ COPD）
cognitive function
Expansive Scale of Dementia （ ESD）
