作者：李科，孙一萌，黄刚

单位：

1.石河子大学医学院第一附属医院心血管内科2.石河子大学医学院第一附属医院医务部3.新疆生产建设兵团第三师总医院心血管内科

单位（英文）：

1.Department of Cardiovascular Medicine, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832008, China 2.Department of Medical, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832008, China 3.Department of Cardiovascular Medicine, General Hospital of the Third Division of Xinjiang Production and Construction Corps, Tumushuke 843900, China

关键词：

心力衰竭; 前临床心力衰竭阶段; 老年人; 轻度认知功能障碍; 影响因素分析;

关键词（英文）：

Heart failure; Preclinical heart failure; Aged; Mild cognitive dysfunction; Root cause analysis

中图分类号：

R 541.62 R 339.34

DOI：

10.12114/j.issn.1008-5971.2022.00.325

基金项目：

摘要：

目的 探讨老年前临床心力衰竭阶段患者发生轻度认知功能障碍（MCI）的影响因素。方法 选取2021年10月至2022年7月就诊于石河子大学医学院第一附属医院的前临床心力衰竭阶段患者204例。依据认知功能评估结果将患者分为MCI组（n=74）和非MCI组（n=130）。比较两组一般资料、药物使用情况、实验室检查指标、心脏彩超检查指标。采用多因素Logistic回归分析探讨老年前临床心力衰竭阶段患者发生MCI的影响因素。结果 两组年龄、工作类型、婚姻状况、失眠者占比、居住情况、睡眠时间、DBP、文化程度、糖尿病发生率、LDL-C、N末端脑钠肽前体（NT-proBNP）、室壁运动异常者占比比较，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，年龄[OR=1.348,95%CI(1.190,1.526)]、婚姻状况[OR=7.272,95%CI(1.713,30.868)]、失眠[OR=5.369,95%CI(1.011,28.511)]、居住情况[OR=7.693,95%CI(1.187,49.873)]、睡眠时间[OR=0.402,95%CI(0.215,0.754)]、文化程度[中学：OR=0.020,95%CI(0.001,0.479)]、糖尿病[OR=5.815,95%CI(1.478,22.877)]、LDL-C[OR=5.727,95%CI(2.307,14.216)]、室壁运动异常[OR=4.931,95%CI(1.216,19.993)]是老年前临床心力衰竭阶段患者发生MCI的影响因素（P<0.05）。结论年龄增大、无配偶、失眠、独居、睡眠时间短、糖尿病、LDL-C升高、室壁运动异常是老年前临床心力衰竭阶段患者发生MCI的危险因素，而中学文化程度是其保护因素。

英文摘要：

Objective To investigate the influencing factors of mild cognitive impairment (MCI) in elderly patients with preclinical heart failure. Methods A total of 204 elderly patients with preclinical heart failure in the Shihezi University School of Medicine First Affiliated Hospital from October 2021 to July 2022 were selected. According to the results of cognitive function assessment, patients were divided into MCI group (n=74) and non-MCI group (n=130) . The general data, drug use, laboratory examination indexes and cardiac color Doppler ultrasound indexes were compared between the two groups. Multivariate Logistic regression analysis was used to explore the influencing factors of MCI in elderly patients with preclinical heart failure. Results There were statistically significant differences in age, job type, marital status, proportion of insomnias, residence situation, sleep time, DBP, education level, incidence of diabetes mellitus, LDL-C, N-terminal brain natriuretic peptide precursor (NT-proBNP) and abnormal ventricular wall movement between the two groups (P < 0.05) . The results of multivariate Logistic regression analysis showed that age [OR=1.348, 95%CI (1.190, 1.526) ] , marital status [OR=7.272, 95%CI (1.713, 30.868) ] , insomnia [OR=5.369, 95%CI (1.011, 28.511) ] , living condition [OR=7.693, 95%CI (1.187, 49.873) ] , sleep duration [OR=0.402, 95%CI (0.215, 0.754) ] , education [middle school: OR=0.020, 95%CI (0.001, 0.479) ] , diabetes [OR=5.815, 95%CI (1.478, 22.877) ] , LDL-C [OR=5.727, 95%CI (2.307, 14.216) ] , wall motion abnormality [ OR=4.931, 95% CI (1.216, 19.993) ] were influencing factors in elderly patients with pre-clinical heart failure (P < 0.05) . Conclusion Older age, no spouse, insomnia, living alone, short sleep duration, diabetes, elevated LDL-C, and wall motion abnormality are risk factors for MCI in elderly patients with pre-clinical heart failure and secondary school education is a protective factor

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