BPV联合血清Hcy的检测在老年衰弱的高血压病人认知功能评估中的价值

    The value of BPV combined with serum Hcy detecction in the assessment of cognitive function in elderly frail patients with hypertension

    • 摘要:
      目的: 探讨血压变异性(blood pressure variability,BPV)与血清同型半胱氨酸(homocysteine,Hcy)联合检测在老年衰弱高血压人群认知功能评估中的价值。
      方法: 纳入2022年10月至2023年10月合肥市第二人民医院全科医学科老年衰弱高血压住院病人(年龄 ≥ 65岁)共106例,根据排除标准采用简易精神状态量表(Mini-mental State Examination,MMSE)评估认知功能,并依据认知功能水平进行分组,分为认知功能障碍组53例,认知功能正常组53例。收集研究对象一般资料、病史资料及实验室检查结果,分析一般资料及其他指标与MMSE得分的相关性,探讨认知功能评估结果的影响因素,ROC曲线评价Hcy、BPV及两者联合式预测模型对认知功能的预测价值。
      结果: 通过Spearman相关性分析发现,Hcy、24 h收缩压变异系数、24 h舒张压变异系数、年龄、尿素、肌酐与MMSE评分负相关关系。多因素logistic回归分析结果显示,Hcy、24 h收缩压变异系数、24 h舒张压变异系数、年龄均是老年人发生认知功能障碍的独立危险因素。
      结论: Hcy、BPV及联合检测都可视为老年衰弱高血压病人认知功能障碍的预测因子,且联合预测老年衰弱高血压病人认知功能水平较单个指标更佳。

       

      Abstract:
      Objective To explore the value of blood pressure variability (BPV) combined with serum homocysteine (Hcy) detection in the assessment of cognitive function in elderly frail hypertensive patients.
      Methods A total of 106 elderly frail patient (aged ≥ 65 years) with hypertension from the General Medical Department of the Second People's Hospital of Hefei from October 2022 to October 2023 were selected. According to the exclusion criteria, the cognitive function of all patients were evaluated using the Mini mental State Examination (MMSE), and the patients were divided intro the cognitive dysfunction group and normal cognitive function group according to their cognitive function levels (53 cases each group). The general information, medical history data and laboratory test results of the patients were collected, the correlation between general information and other indicators and MMSE scores were analyzed, the influencing factors of cognitive function evaluation results were explored, and the ROC curve was used to evaluate the predictive value of Hcy, BPV and their combined prediction models for cognitive function.
      Results The results of Spearman correlation analysis showed that the Hcy, 24-hour systolic blood pressure coefficient of variation, 24-hour diastolic blood pressure coefficient of variation, age, urea, creatinine were negatively correlated with MMSE score. The results of multivariate logistic regression analysis showed that the Hcy, 24-hour systolic blood pressure coefficient of variation, 24-hour diastolic blood pressure coefficient of variation and age were all independent risk factors for cognitive impairment in the elderly.
      Conclusions The Hcy, BPV and their combined detection can be regarded as the predictive factors for cognitive dysfunction in elderly patients with frailty and hypertension, and the combination of the two predicts the cognitive function level of elderly frail hypertensive patients is better than a single indicator.

       

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