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Neurology:房颤、抗血栓治疗与认知衰老

2018-10-11 xing.T MedSci原创

由此可见,房颤与老年人整体认知能力下降速度加快、痴呆风险增加有关。使用抗凝药物可降低房颤患者的痴呆风险。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在探讨房颤(AF)与老年认知功能下降以及痴呆之间的关系,以及探讨AF患者抗血栓治疗的认知益处。

这项基于人群的队列研究包含了来自瑞典国家衰老和护理研究的2685名无痴呆症参与者,他们在2001-2004至2010-2013期间定期接受检查。AF是通过临床检查、ECG和患者登记来确定。使用迷你精神状态检查评估整体认知功能。研究人员遵循DSM-IV标准诊断痴呆,NINDS-AIREN(国立神经疾病和中风研究所和国际神经科学协会)标准诊断血管性痴呆以及NINCDS-ADRDA(全国神经和交流障碍和中风和阿尔茨海默病和相关疾病协会研究所)标准诊断阿尔茨海默病。研究人员使用多个线性混合效应和Cox回归模型来分析数据。

在基线时,研究人员确定了243名AF患者(9.1%)。在9年的随访期间,279名参与者(11.4%)发生了AF,399名(14.9%)参与者患有痴呆症。作为一个时变变量,AF与更快的年度迷你精神状态检查得分下降(β系数=-0.24,95%置信区间[CI]:-0.31至-0.16)以及全因痴呆(HR=1.40,95%CI:1.11至1.77)和血管性、混合性痴呆(HR=1.88,95%CI为1.09至3.23)增加的风险比(HR)显著相关,但与阿尔茨海默病无关(HR=1.33,95%CI为0.92至1.94)。在已患房颤或新发房颤的患者中,使用抗凝药物而非抗血小板治疗与痴呆风险降低60%相关(HR=0.40,95%CI为0.18-0.92)。

由此可见,房颤与老年人整体认知能力下降速度加快、痴呆风险增加有关。使用抗凝药物可降低房颤患者的痴呆风险。

原始出处:

Mozhu Ding,et al. Atrial fibrillation, antithrombotic treatment, and cognitive aging A population-based study.neurology.2018. http://n.neurology.org/content/early/2018/10/10/WNL.0000000000006456

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    2019-06-09 yinhl1978
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    2018-10-13 gwc388
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    2018-10-12 医者仁心5538

    学习了

    0

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    2018-10-11 flysky120

    抗凝药物与痴呆的治疗方案

    0

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