摘要
目的探讨影响冠状动脉旁路移植(CABG)术后患者发生认知功能障碍的风险因素及预防策略。方法研究对象回顾性选自于2021年3月至2023年6月在平顶山市第二人民医院接受CABG治疗的患者151例的临床资料,依据简易精神状态评价量表(MMSE)分为46例认知功能障碍组,105例非认知功能障碍组。比较两组患者临床资料指标,影响CABG术后患者发生认知功能障碍的危险因素采用多因素Logistic回归分析法进行分析,并对应构建受试者工作特征曲线(ROC)预测模型。结果认知功能障碍组与非认知功能障碍组进行比较,合并高血压、合并糖尿病的患者占比、年龄、狭窄程度(Gensini)评分、血清尿酸(UA)水平相对较高,手术时间、ICU时间则较长(P<0.05)。多因素Logistic回归分析结果显示,年龄偏高、合并高血压、合并糖尿病、Gensini评分偏高、手术时间偏长、ICU时间偏长、血清UA水平偏高是影响CABG术后患者发生认知功能障碍的独立风险因素(OR=1.514、1.445、1.484、1.514、1.527、1.418、1.594,均P<0.05)。ROC曲线分析结果显示曲线下面积为0.818,95%CI:0.744~0.878,敏感度为92.68%,特异度为61.62%。结论影响CABG术后患者发生认知功能障碍的风险因素包括年龄偏高、合并高血压、合并糖尿病、Gensini评分偏高、手术时间偏长、ICU时间偏长、血清UA水平偏高,为CABG术后认知功能障碍的早期预警提供新的思路,临床可据此进行有针对性的干预手段,从而减少术后认知功能障碍情况的发生。
Objective To explore the risk factors and preventive strategies of cognitive dysfunction in patients after coronary artery bypass grafting(CABG).Methods The clinical data of 151 patients with coronary heart disease who received CABG in Pingdingshan Second People's Hospital from March 2021 to June 2023 were retrospectively collected and analyzed.According to the Mini Mental State Assessment Scale(MMSE),they were divided into 46 in the cognitive impairment groups and 105 in the non-cognitive impairment groups.The clinical data of the two groups(n=46)and the risk factors of cognitive dysfunction in patients after CABG were analyzed by multivariate Logistic regression analysis,and the corresponding receiver operating characteristic curve(ROC)prediction model was constructed.Results Compared with the non-cognitive impairment group,the proportion,age,Gensini score and serum uric acid(UA)level of patients with hypertension and diabetes were relatively higher,and the operation time and ICU time were longer(P<0.05).The results of multivariate Logistic regression analysis showed that the older age,hypertension,diabetes,higher Gensini score,longer operation time,longer ICU time and higher serum UA level were independent risk factors for cognitive dysfunction in patients after CABG(OR=1.514,1.445,1.484,1.514,1.527,1.418,1.594,P<0.05).The ROC curve analysis showed that the area under curve was 0.818,the 95%CI was 0.744-0.878,the sensitivity was 92.68%,and the specificity was 61.62%.Conclusion Risk factors affecting cognitive dysfunction in patients after CABG include older age,hypertension,diabetes,higher score of Gensini,longer operation time,longer ICU time and higher level of serum UA.It provides a new idea for early warning of cognitive dysfunction after CABG,so that clinical intervention can be carried out accordingly,thus reducing the occurrence of postoperative cognitive dysfunction.
作者
王恒
杨菲菲
邵松海
Wang Heng;Yang Feifei;Shao Songhai(Department of Cardiothoracic Surgery,Pingdingshan Second People's Hospital,Henan Pingdingshan 467000,China)
出处
《中国体外循环杂志》
2024年第4期282-286,共5页
Chinese Journal of Extracorporeal Circulation
关键词
冠状动脉旁路移植术
认知功能障碍
风险因素
预防策略
Coronary artery bypass grafting
Cognitive dysfunction
Risk factors
Preventive strategy
