血清血管紧张素Ⅱ和一氧化氮水平与老年慢性心力衰竭病人认知功能障碍的相关性

doi:10.3969/j.issn.1003-9198.2024.02.006

摘要/Abstract

摘要： 目的探讨血清血管紧张素Ⅱ(AngⅡ)和一氧化氮(NO)水平与老年CHF病人认知功能障碍的相关性,分析AngⅡ、NO对CHF病人认知功能障碍的预测价值。方法选择2020—2022年我院心内科收治的86例老年CHF病人,根据MoCA评分分为认知功能障碍组(MoCA评分<26分)和认知功能正常组(MoCA评分≥26分)。收集病人一般资料,检测血清AngⅡ、NO水平,采用Pearson相关系数描述血清AngⅡ、NO水平与MoCA评分的相关性,采用Logistic回归分析老年CHF病人发生认知功能障碍的影响因素,并采用ROC曲线分析血清AngⅡ、NO对老年CHF病人认知功能障碍的预测价值。结果认知功能障碍组受教育年限>12年比例、LVEF、血清NO水平均低于认知功能正常组,血清AngⅡ水平高于认知功能正常组(P<0.01);Logistic回归分析结果显示,LVEF、NO是老年CHF病人发生认知功能障碍的保护因素,AngⅡ是危险因素;血清AngⅡ、NO对老年CHF病人的认知功能障碍具有预测价值,且二者联合应用的效能更优,灵敏度和特异度分别为82.69%和85.29%。结论老年CHF病人血清AngⅡ水平升高、NO水平降低,且与认知功能障碍有关,AngⅡ、NO联合检测对老年CHF病人发生认知功能障碍具有较好的预测价值。

关键词: 慢性心力衰竭, 认知功能障碍, 血管紧张素Ⅱ, 一氧化氮

Abstract: Objective To investigate the correlation of serum angiotensin Ⅱ(AngⅡ) and nitric oxide(NO) with cognitive dysfunction in the elderly patients with chronic heart failure(CHF), and to analyze the predictive value of AngⅡ and NO for cognitive dysfunction. Methods A total of 86 elderly patients with CHF admitted to Department of Cardiology in our hospital from January 2020 to December 2022 were selected. According to the score of Montreal Cognitive Assessment Scale(MoCA), the patients were divided into cognitive dysfunction group with MoCA score <26 and normal cognitive function group with MoCA score ≥ 26. The general data of the patients were collected, and the serum levels of AngⅡand NO were detected. The correlations of the levels of serum AngⅡand NO with MoCA score were analyzed by Pearson correlation coefficient, and the influencing factors of cognitive dysfunction in elderly patients with CHF were analyzed by Logistic regression. The predictive value of serum AngⅡand NO for cognitive dysfunction in the elderly patients with CHF was analyzed by receiver operating characteristic curve. Results The proportion of education length >12 years, the levels of left ventricular ejection fraction(LVEF) and NO in the cognitive dysfunction group were lower than those in the normal cognitive function group, and the serum level of Ang Ⅱ was higher than that in the normal cognitive function group(P<0.01). Logistic regression analysis showed that LVEF and NO were the protective factors of cognitive dysfunction in the elderly patients with CHF, and AngⅡ was the risk factor. Both AngⅡ and NO had predictive value for cognitive dysfunction in the elderly patients with CHF, and the combination of the two indexes had a better predictive value with the sensitivity of 82.69% and specificity of 85.29%, respectively. Conclusions The levels of AngⅡ and NO are related to the occurrence of cognitive dysfunction in the elderly patients with CHF. The combination of AngⅡ and NO has a better predictive value for the cognitive dysfunction in the elderly patients with CHF.

Key words: chronic heart failure, cognitive dysfunction, angiotensin Ⅱ, nitric oxide

中图分类号:

R 541.6

程清, 徐艳, 陈国飞, 邓心悦. 血清血管紧张素Ⅱ和一氧化氮水平与老年慢性心力衰竭病人认知功能障碍的相关性[J]. 实用老年医学, 2024, 38(2): 132-135.

CHENG Qing, XU Yan, CHEN Guofei, DENG Xinyue. Correlation of serum angiotensin Ⅱ and nitric oxide levels with cognitive dysfunction in elderly patients with chronic heart failure[J]. Practical Geriatrics, 2024, 38(2): 132-135.

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