稳定期慢性阻塞性肺疾病患者的认知功能障碍研究

李新玲+吴振国+++朱颀峰

[摘要] 目的 研究稳定期慢性阻塞性肺疾病（COPD）患者的认知功能障碍。 方法 选择2011年1月～2013年5月在河北医科大学第一附属医院治疗的COPD患者60例及同期健康志愿者60例，分为COPD组及对照组，进行动脉血气分析、肺功能测定及认知功能测定，其中认知功能测定包括注意力、言语学习和记忆、非言语学习和记忆、前额执行功能分等17项内容，比较两组的各项认知功能差异。 结果 COPD组连线测验及数字广度测验-倒背、前额执行功能（除stroop C）测验结果与对照组比较，差异有高度统计学意义（P < 0.01）；COPD组数字广度测验-顺背、言语学习和记忆、即刻和延迟视觉再生测验结果与对照组比较，差异有统计学意义（P < 0.05）。COPD组即刻和延迟再认、stroop C测验结果与对照组比较，差异无统计学意义（P > 0.05）。 结论 稳定期COPD患者广泛存在认知功能障碍，尤其是注意力、前额执行功能、记忆力等功能显著降低，严重影响稳定期COPD患者的治疗效果及生活质量，加快COPD认知功能障碍的治疗及诊断指南的出台，应是广大医务工作者工作的共同目标。

[关键词] 稳定期慢性阻塞性肺疾病；认知功能障碍；肺功能；血气分析

[中图分类号] R583.9 [文献标识码] A [文章编号] 1673-7210（2014）10（a）-0039-04

Cognitive dysfunction study of patients with stable chronic obstructive pulmonary disease

LI Xinling WU Zhenguo ZHU Qifeng▲

The First Hospital of Hebei Medical University， Hebei Province， Shijiazhuang 050000， China

[Abstract] Objective To study cognitive dysfunction of patients with stable chronic obstructive pulmonary disease （COPD）. Methods From January 2011 to May 2013， in the First Hospital of Hebei Medical University， 60 patients with COPD and 60 healthy volunteers at the same period were chosen and divided into the COPD group （60 cases） and the control group （60 cases）， progress in arterial blood gas analysis， pulmonary function， and cognitive function score， cognitive functions determination including attention， verbal learning and memory， non-verbal learning and memory， executive functions forehead grading 17 contents， the differences between the two groups on the cognitive function were compared. Results The results of the connection test and digit span test-recite， forehead executive function （except stroop C） test in COPD group were compared with those in the control group， the differences were statistically significant （P < 0.01）； the results of the digit span test-along the back， verbal learning and memory， immediate and delayed visual reproduction test in COPD group were compared with those in the control group， the differences were statistically significant （P < 0.05）. The results of the immediate and delayed recognition， stroop C test in COPD group were compared with those in the control group， the differences were not statistically significant （P > 0.05）. Conclusion Patients with stable COPD widespread cognitive dysfunction， especially attention， forehead executive function， memory and other functions significantly reduced， seriously affecting the stable COPD patient outcomes and quality of life， to accelerate the treatment of cognitive dysfunction in COPD and diagnostic guidelines the introduction is the majority of medical workers work common goal.

[Key words] Stable chronic obstructive pulmonary disease； Cognitive dysfunction； Pulmonary function； Blood oxygen pressure

慢性阻塞性肺疾病（COPD）是一种存在气流受限的呼吸道疾病，呈进行性发展，可累及肺脏甚至全身，具有致残率、病死率高的特点，随着吸烟、环境污染及老龄化等影响，我国COPD的发病率呈现逐年上升的趋势[1]。认知功能是指处理信息的高级神经活动的总称，包括理解、感知、学习、推理、理解、语言、运动功能等几方面。在大量的不同程度的COPD患者研究中发现了COPD与认知功能之间的密切关系，且随着COPD病情的严重程度及患病时间的推移，认知功能损害会越来越重[2-3]。……