Incalzi R A, Gemma A, Marra C, Muzzolon R, Capparella O, Carbonin P
Università Cattolica del Sacro Cuore, Cattedra di Geriatrica, Rome, Italy.
Am Rev Respir Dis. 1993 Aug;148(2):418-24. doi: 10.1164/ajrccm/148.2.418.
In order to characterize the neuropsychologic profile of patients with hypoxic-hypercapnic chronic obstructive pulmonary disease (COPD), the performance of 36 patients with COPD 69 +/- 10 yr of age (mean +/- SD) on 19 tests exploring eight cognitive domains was compared with those of 29 normal adults (69 +/- 7 yr of age), 20 normal elderly adults (78 +/- 2 yr of age), 26 patients with Alzheimer-type dementia (72 +/- 6 yr of age), and 28 with multi-infarct dementia (MID) (70 +/- 8 yr of age). The discriminant analysis of cognitive test scores showed that 48.5% of patients with COPD had a specific pattern of cognitive deterioration characterized by a dramatic impairment in verbal and verbal memory tasks, well-preserved visual attention, and diffuse worsening of the other functions. The remaining patients with COPD were functionally classified as normal adults (12.1%), normal elderly adults (15.2%), those with MID (12.1%), and those with Alzheimer-type dementia (12.1%) according to discriminant analysis. Cognitive impairment was significantly and positively correlated with age (p < 0.05) and duration of hypoxic-hypercapnic chronic respiratory failure (p < 0.05). Because patients with COPD were receiving oxygen therapy from the beginning of oxyhemoglobin desaturation, results suggest that continuous oxygen therapy does not prevent or only partly prevents cognitive decline in COPD. Although some analogies between age-related and COPD-related cognitive decline are evident, a distinct cognitive profile was found in a large fraction of patients with COPD and it differs in several aspects from those of both normal and demented subjects.
为了描述缺氧 - 高碳酸血症型慢性阻塞性肺疾病（COPD）患者的神经心理学特征，将36例年龄为69±10岁（均值±标准差）的COPD患者在19项探索八个认知领域的测试中的表现，与29名正常成年人（69±7岁）、20名正常老年人（78±2岁）、26例阿尔茨海默病型痴呆患者（72±6岁）以及28例多发梗死性痴呆（MID）患者（70±8岁）的表现进行了比较。认知测试分数的判别分析表明，48.5%的COPD患者具有特定的认知衰退模式，其特征为言语和言语记忆任务严重受损、视觉注意力保存良好，以及其他功能普遍恶化。其余COPD患者根据判别分析在功能上被分类为正常成年人（12.1%）、正常老年人（15.2%）、MID患者（12.1%）以及阿尔茨海默病型痴呆患者（12.1%）。认知障碍与年龄（p < 0.05）以及缺氧 - 高碳酸血症型慢性呼吸衰竭的病程（p < 0.05）显著正相关。由于COPD患者从氧合血红蛋白去饱和开始就接受氧疗，结果表明持续氧疗并不能预防或仅部分预防COPD患者的认知衰退。尽管与年龄相关和与COPD相关的认知衰退之间存在一些明显的相似之处，但在很大一部分COPD患者中发现了独特的认知特征，并且在几个方面与正常和痴呆受试者的认知特征不同。
