[认知障碍住院患者的共病情况调查]

Gong Wen-ping, Guo Qi-hao, Zhao Qian-hua, Hong Zhen

Department of Neurology, Shengzhou People's Hospital, Shengzhou 312400, China.

Zhonghua Yi Xue Za Zhi. 2012 Jan 17;92(3):156-9.

OBJECTIVE

To provide rationales for the prevention and treatment of elderly patients with cognitive disorders through comparing the comorbidities according to different etiologies and severities.

METHODS

Six groups of different cognitive status were selected. There were 438 normal cognitive subjects (NC) from Jing'an community of Shanghai. Five other groups were from the Memory Clinic at our hospital from June 2006 to June 2010. There were subjective memory complaints (n = 443, SMC), mild cognitive impairment (n = 540, MCI), vascular cognitive impairment-non dementia (n = 119, VCI-ND), Alzheimer's disease (n = 337, AD) and vascular dementia (n = 54, VaD). All participants finished a battery of neuropsychological tests and completed the survey of such comorbidities as stroke, conscious disturbance, hypertension, diabetes, head injuries and excessive drinking.

RESULTS

The comorbidity rates of diabetes were 11.4%, 9.9%, 16.1%, 14.2%, 12.4% and 18.5% in 6 groups (NC, SMC, MCI, VCI-ND, AD, VaD) respectively. There were no differences for overall or pairwise chi square tests. The rates of stroke, hypertension and excessive drinking in patients of VCI-ND and VaD were higher than those of SMC, MCI and AD. The comorbidity rates in the VCI-ND and VaD group were 54.6% vs 62.9% for stroke; 61.3% vs 79.6% for hypertension; 22.6% vs 37.0% for excessive drinking. Whereas in the SMC, MCI and AD groups, the rates were 9.4%, 10.9% and 3.0% for stroke; 44.9%, 47.2% and 42.1% for hypertension; 18.0%, 18.3% and 15.1% for excessive drinking. No distinct differences existed for the comorbidity rates among SMC, MCI and AD groups or among different degrees of AD.

CONCLUSION

Etiologies rather than severities determine the different rates of comorbidities in the elders with cognitive impairment.

目的

通过比较不同病因及严重程度的老年认知障碍患者的合并症，为其预防和治疗提供依据。

方法

选取六组不同认知状态的人群。其中438名认知正常的受试者（NC）来自上海静安区社区。另外五组来自我院记忆门诊2006年6月至2010年6月期间的患者，包括主观记忆障碍（n = 443，SMC）、轻度认知障碍（n = 540，MCI）、非痴呆型血管性认知障碍（n = 119，VCI-ND）、阿尔茨海默病（n = 337，AD）和血管性痴呆（n = 54，VaD）。所有参与者均完成了一系列神经心理学测试，并完成了关于中风、意识障碍、高血压、糖尿病、头部外伤和过度饮酒等合并症的调查。

结果

糖尿病的合并症发生率在六组（NC、SMC、MCI、VCI-ND、AD、VaD）中分别为11.4%、9.9%、16.1%、14.2%、12.4%和18.5%。总体或两两卡方检验均无差异。VCI-ND和VaD患者的中风、高血压和过度饮酒发生率高于SMC、MCI和AD患者。VCI-ND和VaD组的中风合并症发生率分别为54.6%和62.9%；高血压为61.3%和79.6%；过度饮酒为22.6%和37.0%。而在SMC、MCI和AD组中，中风发生率分别为9.4%、10.9%和3.0%；高血压为44.9%、47.2%和42.1%；过度饮酒为18.0%、18.3%和15.1%。SMC、MCI和AD组之间或不同程度AD患者之间的合并症发生率无明显差异。