[非体外循环冠状动脉旁路移植术后认知功能障碍的危险因素]

[Risk factors of cognitive impairment after off-pump coronary artery bypass grafting].

作者信息

Cui Qin-tao, Fu Qing-lin, Han Pei-li, Zhang Jie

机构信息

Department of Cardiac Surgery, First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Feb;40(2):104-7.

PMID:22490708

Abstract

OBJECTIVE

To analyze the risk factors of cognitive impairment after off-pump coronary artery bypass grafting (OPCABG).

METHODS

A total of 102 patients [male: 82, age: (65.7 ± 7.1) years] undergoing OPCABG in our hospital between January 2009 and December 2010 were divided into postoperative cognitive dysfunction (POCD) group and non-POCD group by the MMSE questionnaire survey conducted at 7 days pre- and post-operation respectively.

RESULTS

The incidence of POCD was 48.0% (49/102). Multivariate logistic stepwise regression analysis showed: advanced age (OR = 1.32, 95%CI: 1.10 - 1.46, P = 0.002), smoking (OR = 1.26, 95%CI: 1.18 - 1.32, P = 0.001), hypertension (OR = 1.66, 95%CI: 1.36 - 1.78, P = 0.023), diabetes (OR = 1.62, 95%CI: 1.02 - 2.84, P = 0.032), stroke (OR = 3.32, 95%CI: 1.68 - 6.49, P < 0.001), mitral regurgitation (OR = 1.48, 95%CI: 1.26 - 1.89, P < 0.001), and time of wall clamp (OR = 4.84, 95%CI: 1.08 - 7.28, P < 0.001) were independent risk factors of POCD.

CONCLUSION

Advanced age, smoking, hypertension, diabetes, stroke, mitral regurgitation, and prolonged time of wall clamp are major risk factors for POCD in patients undergoing OPCABG.

摘要

目的

分析非体外循环冠状动脉搭桥术（OPCABG）后认知功能障碍的危险因素。

方法

选取2009年1月至2010年12月在我院行OPCABG的102例患者[男性82例，年龄（65.7±7.1）岁]，分别于术前7天和术后7天采用简易精神状态检查表（MMSE）问卷调查，分为术后认知功能障碍（POCD）组和非POCD组。

结果

POCD发生率为48.0%（49/102）。多因素logistic逐步回归分析显示：高龄（OR=1.32，95%CI：1.10 - 1.46，P=0.002）、吸烟（OR=1.26，95%CI：1.18 - 1.32，P=0.001）、高血压（OR=1.66，95%CI：1.36 - 1.78，P=0.023）、糖尿病（OR=1.62，95%CI：1.02 - 2.84，P=0.032）、卒中（OR=3.32，95%CI：1.68 - 6.49，P<0.001）、二尖瓣反流（OR=1.48，95%CI：1.26 - 1.89，P<0.001）及主动脉阻断时间（OR=4.84，95%CI：1.08 - 7.28，P<0.001）是POCD的独立危险因素。