摘要
目的分析血压变异性和血浆Hcy水平与老年双相情感障碍(BD)患者认知损害的关系。方法选取2021年6月—2023年6月在我院就诊的60例老年BD患者,采用蒙特利尔认知评定量表(MoCA)对所有患者的认知功能进行评估,将其分为认知功能障碍(MCI组,36例)和认知功能正常(非MCI组,24例)。采用单因素分析两组患者的一般资料及血压变异性(BPV)和血浆同型半胱氨酸(Hcy)水平,Logistic回归分析老年BD患者的认知损害影响因素,并采用受试者工作特征(ROC)评估BPV联合Hcy水平对老年BD患者认知损害的价值。结果60例老年BD患者中,24例认知功能正常,36例存在认知功能障碍,发生率为60.00%(36/60);与非MCI组相比,MCI组患者的受教育程度较低,精神药物治疗史、贝克-拉范森躁狂量表(BRMS)、汉密尔顿抑郁量表17(HAMD-17)、发病频率、24 h收缩压变异系数(24 h SCV)、24 h舒张压变异系数(24 h DCV)、日间收缩压变异系数(dSCV)、夜间收缩压变异系数(nSCV)、夜间舒张压变异系数(nDCV)、Hcy水平均较高;Logistic结果显示,dSCV、nSCV、nDCV以及Hcy水平较高为老年BD患者认知损害的独立危险因素(P<0.05);经ROC曲线分析,dSCV、nSCV、nDCV以及Hcy水平AUC(95%CI)分别为0.877(0.773~0.951)、0.882(0.804~0.967)、0.749(0.620~0.852)、0.644(0.509~0.763),联合评估AUC(95%CI)为0.955(0.868~0.992),对老年BD患者认知损害的评估价值高于单项指标应用(P<0.05)。结论血压变异性指标dSCV、nSCV、nDCV和血浆Hcy水平与老年BD患者认知损害密切相关,四项联合检测对老年BD患者认知损害具有较高的预测价值。
Objective To analyze the relationship between blood pressure variability,plasma Hcy levels,and cognitive impairment in elderly patients with bipolar disorder(BD).Methods Sixty elderly BD patients who visited our hospital from June 2021 to June 2023 were selected.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate the cognitive function of all patients,who were divided into 36 cases of cognitive impairment(MCI group)and 24 cases of normal cognitive function(non MCI group).Univariate analysis was conducted on the general information,blood pressure variability(BPV),and plasma homocysteine(Hcy)levels of the two groups of patients.Logistic regression analysis was used to identify the factors affecting cognitive impairment in elderly BD patients,and receiver operating characteristic(ROC)was used to evaluate the effect of BPV combined with Hcy levels on elderly BD patients.Results Among the 60 elderly BD patients,24 had normal cognitive function and 36 had cognitive dysfunction,with an incidence rate of 60.00%(36/60).Compared with the non MCI group,the MCI group had lower levels of education,higher incidence frequency,medication,Bech-Rafaelsen Mania rating scale(BRMS),Hamilton depression scale 17(HAMD-17)score,24-hour systolic blood pressure coefficient of variation(24hSCV),24-hour diastolic blood pressure coefficient of variation(24hDCV),diurnal systolic blood pressure coefficient of variation(dSCV),nighttime systolic blood pressure coefficient of variation(nSCV),nDCV(nighttime diastolic blood pressure coefficient of variation),and Hcy levels.The logistic results showed that higher levels of dSCV,nSCV,nDCV,and Hcy were independent risk factors for cognitive impairment in elderly BD patients(P<0.05).According to ROC curve analysis,the AUC(95%CI)of dSCV,nSCV,nDCV,and Hcy levels were 0.877(0.773~0.951)、0.882(0.804~0.967)、0.749(0.620~0.852)、0.644(0.509~0.763),respectively.The combined evaluation AUC(95%CI)was 0.955(0.868~0.992),indicating that the evaluation value of cognitive impairment in elderly BD patients was higher than that of single indicators(P<0.05).Conclusion Blood pressure variability index dSCV,nSCV,nDCV and plasma Hcy levels are closely related to cognitive impairment in elderly BD patients,and the combined detection of the four indicators has high predictive value for cognitive impairment in elderly BD patients.
作者
高帅帅
靳路
安景荣·安治国
徐斌
伊琦忠
GAO Shuaishuai;JIN Lu;AN Jingrong·An Zhiguo;XU Bin;YI Qizhong(Psychological Medicine Center,Xinjiang Mental(Psychological)Clinical Medical Research Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《西部医学》
2025年第8期1189-1193,共5页
Medical Journal of West China
基金
国家自然科学基金项目(81960258)
新疆维吾尔自治区自然科学基金项目(2022D01D6)
青年科研启航专项基金项目(2023YFY-QKQN-61)。
关键词
血压变异性
同型半胱氨酸
认知损害
双相情感障碍
抑郁
Blood pressure variability
Homocysteine
Cognitive impairment
Bipolar disorder
Depressed
