不同运动耐力对高龄慢性心力衰竭患者认知功能的影响
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摘要
目的探讨运动耐力能否对高龄慢性心力衰竭(chronic heart failure,CHF)患者认知功能起到影响作用。方法选取2017年和2018年江苏省荣军医院住院治疗及无锡市山北街道社区康复的高龄CHF患者139例作为研究对象,使用蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)对认知功能进行评估,以MoCA评分总分<26分为标准,将研究对象分成认知功能正常组和认知功能损伤组,并比较两组6min步行距离的差异。按照6min运动米数<300m、300～375m、>375m为标准,将CHF组患者分成三组,比较三组认知功能的差异。结果高龄CHF患者认知功能损伤的发生率较高,达78.9%。认知功能损伤组6min运动距离比认知功能正常组短,存在统计学差异(P均<0.05)。不同运动耐力的CHF患者认知功能比较,运动耐力越差,认知功能越差,存在统计学差异(P均<0.05)。结论 CHF患者认知功能损伤发生率较高,并且受到运动耐力的影响。
Objective To explore the effect of exercise endurance on cognitive function in elderly patients with chronic heart failure(CHF). Methods 139 elderly CHF patients hospitalized in Rongjun Hospital of Jiangsu Province and community rehabilitation in Shanbei Street of Wuxi City in 2017 and 2018 were selected as the study subjects. Cognitive function was assessed by Montreal Cognitive Assessment Scale(MoCA). The total score of MoCA was less than 26. The subjects were divided into two groups: normal cognitive function group and cognitive impairment group. The difference of walking distance between clocks was compared. The CHF patients were divided into three groups according to the six-minute exercise metres <300 metres, 300～375 metres and >375 metres. The difference of cognitive function was compared among the three groups.Results The incidence of cognitive impairment was 78.9% in elderly CHF patients. The six-minute motor distance in cognitive impairment group was shorter than that in normal cognitive function group, with statistical difference(P<0.05). Compared the cognitive function of CHF patients with different exercise endurance, the worse the exercise endurance, the worse the cognitive function, there were statistical differences(P<0.05).Conclusion The incidence of cognitive impairment is higher in CHF patients, and it is affected by exercise endurance.
Objective To explore the effect of exercise endurance on cognitive function in elderly patients with chronic heart failure(CHF). Methods 139 elderly CHF patients hospitalized in Rongjun Hospital of Jiangsu Province and community rehabilitation in Shanbei Street of Wuxi City in 2017 and 2018 were selected as the study subjects. Cognitive function was assessed by Montreal Cognitive Assessment Scale(MoCA). The total score of MoCA was less than 26. The subjects were divided into two groups: normal cognitive function group and cognitive impairment group. The difference of walking distance between clocks was compared. The CHF patients were divided into three groups according to the six-minute exercise metres <300 metres, 300～375 metres and >375 metres. The difference of cognitive function was compared among the three groups.Results The incidence of cognitive impairment was 78.9% in elderly CHF patients. The six-minute motor distance in cognitive impairment group was shorter than that in normal cognitive function group, with statistical difference(P<0.05). Compared the cognitive function of CHF patients with different exercise endurance, the worse the exercise endurance, the worse the cognitive function, there were statistical differences(P<0.05).Conclusion The incidence of cognitive impairment is higher in CHF patients, and it is affected by exercise endurance.
引文
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[7] FAGGIANO P,D’ALOIA A,GUALENI A,et a1.Assessment of oxygen uptake during the 6-minute walking test in patients with heart failure:preliminary experience with a portable device[J].Am Hearl J,1997,134(9):203-206.
[2] MCMURRAY J J,ADAMOPOULOS S,ANKER S D,et al.ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012:the Task Force for the Diagnosis and Treatment of Acute andChronic Heart Failure 2012 of the European Society of Cardiology.Developed in collaboration with the Heart Failure Association (HFA) of the ESC[J].Eur J HeartFail,2012,14(8):803-869.
[3] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[4] 王炜,靳慧,丁斌蓉,等.北京版MoCA在长沙地区缺血性脑血管病人群中的应用及长沙版MoCA的形成[J].中国神经精神疾病杂志,2011,37(4):349-353.
[5] CAHALIN L P,MATHIER M A,SEMIGRAN M J,et a1.The six-minute walk test predicts peak oxygen uptake and survival in patients with advanced heart failure[J].Chest,1996,110(10):325-332.
[6] ROSANO C,VENKATRAMAN V K,GURALNIK J,et al.Psychomotor speed and functional brain MRI 2 years after completing a physical activity treatment[J].J Gerontol A Biol Sci Med Sci,2010,65(6):639-647.
[7] FAGGIANO P,D’ALOIA A,GUALENI A,et a1.Assessment of oxygen uptake during the 6-minute walking test in patients with heart failure:preliminary experience with a portable device[J].Am Hearl J,1997,134(9):203-206.