Department of Neurology and Psychiatry,Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,Mexico City,Mexico.
Department of Immunology and Rheumatology,Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,Mexico City,Mexico.
J Int Neuropsychol Soc. 2019 Jul;25(6):595-602. doi: 10.1017/S1355617719000262. Epub 2019 Apr 29.
To characterize cognitive function in patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) in comparison with other chronic conditions, and to investigate its association with disease activity, and other psychological factors.
Cross-sectional study including patients with AAV, rheumatoid arthritis (RA) (n = 30), and chronic kidney disease (CKD) (n = 29). Patients underwent a standardized neuropsychological battery (NEUROPSI). Sleep quality, fatigue, depression, and anxiety levels were assessed.
A total of 60 patients with AAV were included, median age of 54 years, and disease duration of 5.6 years. Prevalence of cognitive dysfunction (CD) in AAV patients was similar to RA and CKD (35%, 40%, and 39.3%, respectively, p = .88). When AAV patients with (n = 21) and without (n = 39) CD were compared, significantly more patients with CD had high disease activity (67% vs. 31%, p = .009). Abnormal performance was more frequent in the executive functions in the three groups (45% AAV, 51.7% RA, and 50% CKD), followed by language (25%, 13.8%, and 25%, respectively). Verbal and visual attentional tests were more frequently impaired in patients from the CKD group (p = .021), and psychomotor functions were more frequently affected in AAV patients (p < .05). Hospital Anxiety and Depression Scale (HADS) total score (especially anxiety) was higher in patients with memory impairment than in those with normal memory function (M = 6.79, SD = 4.53 vs. M = 4.5, SD = 3.6, p < .01). Neither Sleep Quality Index nor fatigue scale scores differed between those cognitively impaired and not impaired.
No statistically significant differences were found in the frequency of CD among the three clinical populations. (JINS, 2019, 25, 595-602).
与其他慢性疾病相比，明确抗中性粒细胞胞浆抗体（ANCA）相关性血管炎（AAV）患者的认知功能，并探讨其与疾病活动度以及其他心理因素的关系。
本研究为横断面研究，共纳入 AAV 患者（n=60）、类风湿关节炎（RA）患者（n=30）和慢性肾脏病（CKD）患者（n=29）。所有患者均接受了标准化的神经心理学测试（NEUROPSI），并评估了睡眠质量、疲劳、抑郁和焦虑水平。
共纳入 60 例 AAV 患者，中位年龄 54 岁，中位病程 5.6 年。AAV 患者认知功能障碍（CD）的发生率与 RA 和 CKD 患者相似（分别为 35%、40%和 39.3%，p=0.88）。与无 CD 的 AAV 患者（n=39）相比，有 CD 的 AAV 患者（n=21）疾病活动度更高（67% vs. 31%，p=0.009）。三组患者的执行功能异常更为常见（AAV 患者 45%，RA 患者 51.7%，CKD 患者 50%），其次为语言功能（25%、13.8%和 25%）。CKD 组患者的言语和视觉注意力测试更易受损（p=0.021），AAV 患者的精神运动功能更易受损（p<0.05）。与记忆正常的患者相比，有记忆障碍的患者的医院焦虑和抑郁量表（HADS）总分（尤其是焦虑）更高（M=6.79，SD=4.53 vs. M=4.5，SD=3.6，p<0.01）。认知障碍患者与无认知障碍患者的睡眠质量指数和疲劳量表评分无差异。
在这三种临床人群中，CD 的发生率无统计学差异。
