慢性阻塞性肺病患者的认知障碍

A. P. Kopylova, V. Zakharov, N. V. Vakhnina
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引用次数: 0

摘要

我们对2010年至2022年发表的23项原创研究进行了系统综述,共有16.8万人参与,其中包括4.8万名年龄在45岁至93岁之间的慢性阻塞性肺病(COPD)患者。后果COPD患者的认知障碍(CI)患病率在6%至63%之间。COPD患者发生轻度CI(HR从1.1到1.9;OR从1.4到2.4)和痴呆(HR从1.3到1.9;OR=1.2)的风险更高。认知功能障碍的风险随着1秒用力呼气量值(FEV1%)(OR=1.34)、动脉氧分压(PaO2)(OR=5.45),氧饱和度(SaO2)和动脉二氧化碳分压(PaCO2)水平的增加。FEV1%与简易精神状态检查(MMSE)之间存在显著的直接关系(p<0.0001),COPD严重程度与MMSE之间存在反比关系(p>0.0001)。MMSE评分与FEV1%(r=0.46,p<0.01)和PaO2(r=0.4 3,p<0.05)相关。结论:现有数据证实COPD与CI发生和发展风险增加有关。据讨论,这是由于在慢性缺氧的背景下伴随血管和神经退行性疾病的不利过程。
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Сognitive impairment in patients with chronic obstructive pulmonary disease
We conducted a systematic review of 23 original studies published from 2010 to 2022, which participated a total of 168 thousand people, including 48 thousand patients with chronic obstructive pulmonary disease (COPD) aged 45 to 93 years.Results. The prevalence of cognitive impairment (CI) in patients with COPD varies from 6 to 63%. COPD patients have a higher risk of developing mild CI (HR from 1.1 to 1.9; OR from 1.4 to 2.4) and dementia (HR from 1.3 to 1.9; OR = 1.2). The risk of cognitive dysfunction increases along with a decrease in the values of forced expiratory volume in one second as a percentage of its expected value (FEV1%) (OR = 1.34), arterial oxygen partial pressure (PaO2) (OR = 5.45), oxygen saturation (SaO2) and an increase in the level of arterial carbon dioxide partial pressure (PaCO2). There is a significant direct relationship between FEV1% and Mini-Mental State Examination (MMSE) (p < 0.0001) and an inverse relationship between COPD severity and MMSE (p < 0.0001). The MMSE score is correlated with FEV1% (r = 0.46, p < 0.01) and PaO2 (r = 0.43, p < 0.05).Conclusion. The available data confirm the association of COPD with an increased risk of occurrence and progression of CI. It is discussed that this is due to the unfavorable course of concomitant vascular and neurodegenerative diseases against the background of chronic hypoxia.
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来源期刊
Russian Neurological Journal
Russian Neurological Journal Medicine-Neurology (clinical)
CiteScore
0.40
自引率
0.00%
发文量
49
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