摘要
背景慢性病是轻度认知障碍(MCI)发生的独立危险因素,服用或联合应用药物可能伴随躯体疾病共同加重认知负荷。目前,我国鲜有研究报道MCI人群的用药特征及其与认知功能的关系。目的了解社区MCI人群药物使用情况,探索药物使用特征对认知功能的影响规律。方法采取抽签法随机选取浙江省湖州市6所社区496例MCI患者,运用一般资料调查表、疾病与用药情况调查表及蒙特利尔认知评估量表(MoCA)北京版进行调查。比较MoCA北京版得分在不同被试特征中的分布差异及服药组与非服药组被试MoCA北京版得分的差异;在控制协变量的基础上,采用多元线性回归分析药物对MCI患者认知的影响。结果不同性别、年龄、受教育程度、职业性质、婚姻状况及躯体疾病分类(高血压及睡眠障碍)被试MoCA北京版得分比较,差异有统计学意义(P<0.05)。β-受体阻滞剂、镇静剂服用组被试的MoCA北京版得分低于非服用组(P<0.05),血管紧张素转换酶抑制剂(ACEI)服用组被试的MoCA得分高于非服用组(P<0.05);钙通道阻滞剂+β-受体阻滞剂联合、钙通道阻滞剂+血管紧张素Ⅱ受体阻滞剂(ARB)联合、β-受体阻滞剂+ARB联合、降糖药+降压药+他汀类药物联合服用组被试的MoCA得分低于非服用组,差异有统计学意义(P<0.05)。多元线性回归分析显示,在控制人口学及躯体疾病特征后,β-受体阻滞剂、ACEI、镇静剂、钙通道阻滞剂+ARB联合用药、β-受体阻滞剂+ARB联合用药、降糖药+降压药+他汀类药物联合用药对社区MCI人群认知功能得分变异的总体贡献率为39.4%(F=23.946,P<0.001)。结论β-受体阻滞剂、镇静剂类药物及药物之间的联合服用可能伴随躯体疾病共同损害认知功能;针对伴有躯体疾病的MCI人群,医务人员在积极开发躯体疾病替代性治疗技术及认知功能训练技术的同时,还应提高对药物知识的掌握程度,针对长期服药�
Background Chronic diseases are independent risk factors for mild cognitive impairment(MCI),and alone use or combination use of drugs may increase cognitive load together with physical diseases.There are limited studies about the relationship between medication characteristics and cognitive function in MCI population in China.Objective To investigate the impact of drug use on cognitive impairment in MCI population in the community.Methods Totals of 496 MCI suffers were randomly selected from 6 communities in Huzhou,Zhejiang Province.General Information Questionnaire,Drug Use and Disease Status Questionnaire and the Beijing version of the Montreal Cognitive Assessment(MoCA-B)were used to survey the participants.The MoCA-B score was compared by sociodemographic factors,and medication use and medication type prevalence.After controlling the covariates,multiple linear regression was used to analyze the effects of medication-related factors on the cognitive function of MCI patients.Results There were statistically significant differences in MoCA-B scores of different gender,age,education level,occupation nature,marital status and classification of physical diseases(hypertension and sleep disorder)(P<0.05).The scores of MoCA-B ofβ-blocker and sedative group were lower than those of non-taking group(P<0.05),and the scores of MoCA-B in angiotensin converting enzyme inhibitor(ACEI)group were higher than those in non-taking group(P<0.05);The MoCA-B scores of the subjects in the combination of calcium channel blocker+β-blocker,calcium channel blocker+angiotensinⅡreceptor blocker(ARB),β-blocker+ARB,hypoglycemic drug+antihypertensive drug+statins combination group were lower than those of the non-taking group.Multiple linear regression analysis found thatβ-blockers,sedatives,ACEI,and calcium channel blockers in combination with ARB,β-blockers in combination with ARB,hypoglycemic drugs in combination with anti-hypertensive agents or statins were associated with increased risk of deterioration of cognitive functions,with
作者
王凤
王丽娜
沈鑫华
葛晨希
周燕茹
张晨
WANG Feng;WANG Lina;SHEN Xinhua;GE Chenxi;ZHOU Yanru;ZHANG Chen(Medical School,Huzhou University,Huzhou 313000,China;Psychosomatic Disorder Department,the Third People's Hospital of Huzhou,Huzhou 313000,China;Binhu Community Health Center,Huzhou 330502,China)
出处
《中国全科医学》
CAS
北大核心
2020年第31期4007-4012,共6页
Chinese General Practice
基金
国家自然科学基金项目(71704053)
国家留学基金委项目(201908330251)
浙江省自然科学基金项目(LQ17G030002)
2018年湖州市科技局公益性研究计划项目(2018GYB61)。
