The Evaluation of Cognitive Impairment and Relevant Factors in Patients with Chronic Obstructive Pulmonary Disease
The Evaluation of Cognitive Impairment and Relevant Factors in Patients with Chronic Obstructive Pulmonary Disease
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慢性阻塞性肺疾病患者认知障碍及相关因素的评价
DOI：
10.1159/000342970
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发表时间：
2013-01-01
期刊：
影响因子：
3.7
通讯作者：
Fei, Guang-He
中科院分区：
文献类型：
--
作者：
Li, Jing;Huang, Yun;Fei, Guang-He
背景：慢性阻塞性肺疾病（COPD）被认为是一种复杂的多成分疾病。认知障碍是持久而深远的。然而，人们对认知能力下降的模式和潜在的不利因素知之甚少。目的：评价COPD患者的认知表现及相关因素，探讨认知缺陷与疾病严重程度分级的关系。方法：招募 27 名轻中度 COPD 患者、35 名重度 COPD 患者和 27 名对照受试者。认知状态通过简易精神状态检查（MMSE）进行调查。对每个受试者的肺功能、动脉血气和血清簇蛋白水平进行了评估。结果：与对照组相比，轻中度COPD患者的MMSE评分较低，血清簇蛋白浓度较高，而重度COPD患者的MMSE评分最低，血清簇蛋白水平最高。在轻中度和重度 COPD 患者中，MMSE 评分与动脉氧分压呈正相关，与血清簇蛋白水平呈负相关。此外，严重 COPD 患者的 MMSE 评分和血清簇蛋白浓度与 1 秒用力呼气量相关。结论：COPD患者存在认知障碍。它与疾病严重程度的分类、低氧血症和血清簇蛋白水平相关。血清簇蛋白水平升高可能是 COPD 患者认知功能障碍的相关外周生物标志物。
Background: Chronic obstructive pulmonary disease (COPD) is understood to be a complex multicomponent disorder. The impairment of cognition is lasting and profound. However, the pattern of the cognitive decline and potentially adverse factors are poorly understood. Objectives: To evaluate the cognitive performances and the relevant factors in COPD patients and to investigate the relationship between cognition deficits and the classification of severity of the disease. Methods: Twenty-seven mild-to-moderate COPD patients, 35 severe COPD patients and 27 control subjects were recruited. Cognitive states were investigated by the Mini-Mental State Examination (MMSE). Pulmonary function, arterial blood gas and serum clusterin level were evaluated in each subject. Results: Lower MMSE score and higher serum clusterin concentration were observed in mild-to-moderate COPD patients, while the lowest MMSE score and the highest serum clusterin level were found in severe COPD patients when compared with control subjects. MMSE score is positively correlated with arterial oxygen tension and is inversely associated with serum clusterin level in both mild-to-moderate and severe COPD patients. Furthermore, MMSE scores and serum clusterin concentrations were correlated with forced expiratory volume in 1 s in severe COPD patients. Conclusion: Cognitive impairment was found in COPD patients. It is associated with the classification of disease severity, hypoxemia and serum clusterin level. An increased serum clusterin level may be a relevant peripheral biomarker of cognitive dysfunction in COPD patients.