摘要
目的探讨不同海拔高度人群认知功能障碍的影响因素。方法分别选取2024年2—10月北京(海拔50 m)、西宁(海拔2260 m)和玉树囊谦(海拔3600 m)常住居民426名、459名和264名。通过近红外光谱技术(near-infrared spectroscopy,NIRS)测量脑氧饱和度(regional cerebral oxygen saturation,rSO_(2)),并使用简易精神状态检查量表(mini-mental state examination,MMSE)和蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评估认知功能,采用多因素非条件logistic回归方程分析不同海拔高度人群认知功能障碍的影响因素。结果1149名人群中男315名、女834名;平均年龄41(36,54)岁。1149名居民中,认知功能障碍312例(27.15%)。北京、西宁、玉树囊谦居民的rSO_(2)和SpO_(2)分别为71.00(67.00,74.25)%和97.00(95.50,98.00)%、67.00(63.00,71.00)%和96.00(92.00,98.00)%、61.00(53.25,67.75)%和89.00(83.00,92.00)%,3组rSO_(2)和SpO_(2)的比较,差异有统计学意义(P<0.05)。多因素回归分析结果显示,西宁地区(OR=2.940,95%CI:1.053~8.209,P=0.040)、文化程度为初中及以下(OR=20.414,95%CI:8.018~51.978,P<0.001)、SpO_(2)越低(OR=0.740,95%CI:0.668~0.819,P<0.001)和rSO_(2)越低(OR=0.927,95%CI:0.883~0.974,P<0.001)的居民,发生认知功能障碍的风险越高。结论高海拔居民因长期慢性缺氧,rSO_(2)降低风险增高,易导致认知功能障碍与神经系统损伤。维持正常rSO_(2)水平是预防的关键,可采取提升氧储备等措施保障脑氧代谢平衡、预防脑缺血缺氧,减少认知功能障碍及相关并发症的发生。
Objective To explore the influencing factors of cognitive dysfunction in people at different altitudes.Methods A total of 426,459,and 264 permanent residents were selected from Beijing(50 m above sea level),Xining(2260 m above sea level),and Yushu Nangqian(3600 m above sea level)from February to October,2024 respectively.Nearinfrared spectroscopy(NIRS)was employed to measure regional cerebral oxygen saturation(rSO_(2)),cognitive function was assessed using the mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA).Multivariate unconditional logistic regression was applied to influencing factors of cognitive dysfunction in people at different altitudes.Results There were 315 males and 834 females among the 1149 people with an average age of 41(36,54)years.Among 1149 residents,312 cases of cognitive dysfunction were identified(27.15%).The rSO_(2) and SpO_(2) of residents in Beijing,Xining and Yushu Nangqian was 71.00(67.00,74.25)%and 97.00(95.50,98.00)%,67.00(63.00,71.00)%and 96.00(92.00,98.00)%、61.00(53.25,67.75)%and 89.00(83.00,92.00)%,respectively.Significant differences in rSO_(2) and SpO_(2) levels were observed among the three groups(P<0.05).Multivariate regression analysis revealed that residents from Xining district(OR=2.940,95%CI:1.053-8.209,P=0.040)and residents with education level of junior high school or below(OR=20.414,95%CI:8.018-51.978,P<0.001),lower levels of SpO_(2)(OR=0.740,95%CI:0.668-0.819,P<0.001)and lower levels of rSO_(2)(OR=0.927,95%CI:0.883-0.974,P<0.001)had a significantly higher risk of cognitive dysfunction.Conclusions Chronic hypoxia at high altitudes increases the risk of reduced rSO_(2) in residents,predisposing them to cognitive impairment and neurological damage.Maintaining normal rSO_(2) levels is crucial for prevention.Interventions such as enhancing oxygen reserve capacity can safeguard cerebral oxygen metabolic homeostasis,prevent cerebral ischemic hypoxia,and reduce the incidence of cognitive function disorders and related complications.
作者
武屹爽
朱晓红
郑继铭
李桂宇
袁红
李赟赟
王忠昌
菅敏钰
王学军
刘海洋
Wu Yishuang;Zhu Xiaohong;Zheng Jiming;Li Guiyu;Yuan Hong;Li Yunyun;Wang Zhongchang;Jian Minyu;Wang Xuejun;Liu Haiyang(Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《北京医学》
2025年第7期582-587,594,共7页
Beijing Medical Journal
基金
青海省科技计划(2023-ZJ-753)。
关键词
脑氧饱和度
认知功能障碍
血氧饱和度
海拔
regional cerebral oxygen saturation(rSO_(2))
cognitive dysfunction
oxygen saturation
altitude
