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[与认知障碍相关的稳定期慢性阻塞性肺疾病:可能的因果因素]

[Stable Chronic Obstructive Pulmonary Disease Associated With Cognitive Impairment: Possible Causality Factor].

作者信息

Varela Lucía Belen, Correa Facundo, Cazaux Alexis, Spaccesi Agostina, Salica Daniel Antonio, Vanoni Susana

机构信息

Hospital Italiano de Buenos Aires. Servicio de Neurología.

Universidad Nacional de Córdoba.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2021 Jun 28;78(2):97-102. doi: 10.31053/1853.0605.v78.n2.28721.

Abstract

BACKGRUOUND

Chronic Obstructive Pulmonary Disease (COPD), a preventable and underdiagnosed pathology, can be defined as a progressive and poorly reversible limitation to airflow as a result of a persistent inflammatory response due to inhalation of harmful substances, particularly tobacco smoke. The disease has a systemic impact. Among other conditions, it may increase the risk of cognitive impairment along with its associated consequences.

METHODS

Prospective, cross-sectional, observational and analytical design. The space were COPD patients who visited in two health institutions from June 2017 to September 2018. Non-probabilistic and convenience sampling. Data were collected on demographics, tobacco consumption, comorbidities (Charlson index), a validated scale for dyspnea (MCRm), the main symptom in COPD and the COPD Assessment Test (CAT) were applied along with a history of exacerbation of the disease. The severity of COPD was evaluated by spirometry according to GOLD guideline. Cognitive impairment was assessed using Neuropsi.

OUTCOMES

The final sample consisted of 44 subjects. According to spirometry and GOLD, 7 patients (15.9%) classified in group 1 (mild), 19 (43.2%) in group 2 (moderate), 11 (25%) in group 3 (severe) and 7 (15.9%) in group 4 (very serious). Of the 44 patients recruited, 28 (63.6%) had normal cognitive function and 16 (36.3%) had some degree of cognitive impairment. Memory was the most compromised function.

CONCLUSION

Difficulties in recruitment impeded reaching the expected sample size. However, a trend was observed favoring the association. It is important to insist on avoiding smoking because it seems to increase the risk of cognitive impairment that further disrupts the quality of life and makes treatment difficult.

摘要

背景

慢性阻塞性肺疾病(COPD)是一种可预防但诊断不足的病理状态,可定义为由于吸入有害物质,特别是烟草烟雾导致的持续性炎症反应,从而引起的气流进行性且难以逆转的受限。该疾病具有全身性影响。在其他情况中,它可能会增加认知障碍及其相关后果的风险。

方法

前瞻性、横断面、观察性和分析性设计。研究对象为2017年6月至2018年9月期间在两家医疗机构就诊的COPD患者。采用非概率和便利抽样。收集了人口统计学、烟草消费、合并症(查尔森指数)、一种经过验证的呼吸困难量表(MCRm)、COPD的主要症状以及COPD评估测试(CAT)的数据,并记录了疾病加重史。根据GOLD指南通过肺功能测定评估COPD的严重程度。使用Neuropsi评估认知障碍。

结果

最终样本包括44名受试者。根据肺功能测定和GOLD标准,7名患者(15.9%)归类为1组(轻度),19名(43.2%)为2组(中度),11名(25%)为3组(重度),7名(15.9%)为4组(极重度)。在招募的44名患者中,28名(63.6%)认知功能正常,16名(36.3%)有一定程度的认知障碍。记忆是受影响最严重的功能。

结论

招募困难阻碍了达到预期样本量。然而,观察到一种有利于该关联的趋势。坚持避免吸烟很重要,因为吸烟似乎会增加认知障碍的风险,进而进一步扰乱生活质量并使治疗变得困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e97/8628825/f1b6d5610a5c/1853-0605-78-2-97-g001.jpg

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