摘要
目的:探讨老年高血压患者24h动态血压节律及血脂代谢紊乱对老年术后认知功能障碍的影响.方法:对全麻下择期行非心脏手术且年龄≥60岁的老年患者测定术前血脂、24h动态血压.依据WHO/ISH高血压诊断标准将62例受试者按24h动态血压节律类型及有无血脂代谢紊乱分为4组:杓型高血压(15例);杓型高血压加血脂代谢紊乱组(18例);非杓型高血压组(13例);非杓型高血压加血脂代谢紊乱组(16例).术前及术后第7日用简易智能状态检查表(MMSE)对所有受试者进行认知功能调查.结果:非杓型高血压加血脂代谢紊乱组的MMSE的分值为(24.2±1.6)分,与杓型高血压加血脂代谢紊乱组(26.5±1.4)分及非杓型高血压组(26.8±1.3)分比较,差异有统计学意义(P<0.05),非杓型高血压加血脂代谢紊乱组与杓型高血压组(28.3±0.6)分比较,差异有统计学意义(P<0.01).结论:血压昼夜节律减弱或消失与老年高血压患者的术后认知功能损害相关,血脂代谢紊乱的形成对老年术后认知功能损害有协同作用.
AIM： To explore the effects of 24-h dynamic blood pressure rhythm and blood-fat metabolic disorder on postoperative cognitive dysfunction in elderly hypertensive patients. METHODS： Preoperative blood-fat and 24-h dynamic blood pressure were determined in the elderly patients （ ≥ 60 years of age） with postoperative cognitive dysfunction （ POCD ） undergoing noncardiac surgery. According to WHO/ISH hypertension diagnostic criteria,24-h dynamic blood pressure and blood-fat examination, 62 subjects were divided into 4 groups, namely, dipper hypertension group （ n = 15 ）, dipper hypertension and blood-fat metabolic disorder group（ n = 18 ） , non-dipper hypertension group （n = 13 ） and non-dipper hypertension and blood-fat metabolic disorder group （n = 16 ）. All subjects were evaluated by Mini- Mental State Examination（MMSE） before and 7 d after operation. RESULTS： There were significant differences in MMSE scores between non-dipper hypertension and blood-fat metabolic disorder group and dipper hypertension and blood-fat metabolic disorder group and non-dipper hypertension group （24.2 ± 1.6, 26.5 ± 1.4 and 26.8 ± 1.3, respectively, P 〈 0.05 ）. There was significant difference between non-dipper hypertension and blood-fat metabolic disorder group and dipper hypertension group （24.2 ± 1.6 and 28.3 ± 0.6, P 〈 0.01 ）. CONCLUSION ： The circadian rhythm variance of blood oressure is associated with the damage of cognitive function in elderly hypertensive patients with postoperative cognitive dysfunction. Elderly postoperative cognitive function is damaged by synergistic effect of rhythm variance of blood pressure and blood-fat metabolic disorder.
出处
《第四军医大学学报》
北大核心
2008年第17期1590-1592,共3页
Journal of the Fourth Military Medical University
关键词
认知障碍
手术并发症
高血压
昼夜节律
血脂代谢紊乱
老年人
postoperative complication
cognitive disorder
hypertension
circadian rhythm
lipid metabolism disorder
aged
