Liesker Jeroen J W, Postma Dirkje S, Beukema Rypko J, ten Hacken Nick H T, van der Molen Thys, Riemersma Roland A, van Zomeren Ed H, Kerstjens Huib A M
Department of Pulmonary Diseases, University Hospital Groningen, Hanzeplein 1, Postbox 30001 NL-9700-RB, Groningen, The Netherlands.
Respir Med. 2004 Apr;98(4):351-6. doi: 10.1016/j.rmed.2003.11.004.
Hypoxemic patients with Chronic Obstructive Pulmonary Disease (COPD) have impaired cognitive performance. These neuropsychological impairments are related to the degree of hypoxemia. So far, cognitive performance has not been tested in non-hypoxemic patients with COPD.
We recruited patients with stable COPD and PaO2 > 8.0 kPa (60 mmHg), as well as healthy subjects, who were matched for age, intelligence quotient (IQ), and level of education. Cognitive performance was studied by Stroop Colour Word Test, Trailmaking, digit-symbol of the Wechsler Adult Intelligence Scale, addition subtest of the Groningen Intelligence Test, and Story Recall.
Thirty patients with COPD (FEV1 49.8% pred, mean age 64.8 yr) and 20 healthy volunteers (65.6 yr) were enrolled. COPD patients performed significantly worse on trailmaking B, the digit-symbol test, and on the addition subtest. There was no significant correlation between the tests of cognitive performance and disease specific health status (Chronic Respiratory Questionnaire).
We conclude that even non-hypoxemic patients with COPD show significant impairments in cognitive performance. These impairments are not associated with deteriorations in health related quality of life. Prospective evaluation of the impact of treatment on cognitive performance in non-hypoxemic patients with COPD would be a logical subsequent study.
慢性阻塞性肺疾病(COPD)低氧血症患者存在认知功能损害。这些神经心理学损害与低氧血症程度相关。迄今为止,尚未对非低氧血症COPD患者的认知功能进行测试。
我们招募了稳定期COPD且动脉血氧分压(PaO2)>8.0kPa(60mmHg)的患者以及年龄、智商(IQ)和教育水平相匹配的健康受试者。通过Stroop颜色词测试、连线测验、韦氏成人智力量表数字符号测验、格罗宁根智力测验加法分测验和故事回忆来研究认知功能。
纳入30例COPD患者(第1秒用力呼气容积[FEV1]为预计值的49.8%,平均年龄64.8岁)和20名健康志愿者(65.6岁)。COPD患者在连线测验B、数字符号测验和加法分测验中的表现明显更差。认知功能测试与疾病特异性健康状况(慢性呼吸问卷)之间无显著相关性。
我们得出结论,即使是非低氧血症COPD患者也存在明显的认知功能损害。这些损害与健康相关生活质量的恶化无关。对非低氧血症COPD患者治疗对认知功能影响的前瞻性评估将是一项合理的后续研究。