Alzheimer's Dementia :瑞典30万大数据研究:心脏搭桥后的痴呆风险和普通人无异

2021-03-18 Freeman MedSci原创

瑞典30万大数据研究:心脏搭桥后的痴呆风险和普通人无异

冠状动脉搭桥术(CABG)是复杂多血管或左主干冠状动脉疾病患者心肌血管重建的首选方法,CABG仍是最常用的心脏外科手术,美国每年进行≈40万例手术。

自开放性心脏手术出现以来,术后认知功能障碍一直是一个严重的问题,尤其是老年患者。一直有报道称CABG术后最初几周内谵妄和认知功能障碍的发生率很高。

术后早期的认知功能下降通常是短暂的,但有时可持续数月。早期认知功能障碍的确切机制尚未定论,但有人认为心肺分流术和微栓塞过程中的脑缺血是原因之一。

虽然CABG和其他心脏手术后的早期认知功能障碍已被文献充分认识和描述,但心脏手术与慢性认知功能障碍(即痴呆)之间的长期关联却不太明显。以往的研究显示出相互矛盾的结果,并且往往受到研究人群和随访时间的限制。以往的研究没有调查过CABG患者是否存在发生痴呆风险增加的亚组。有一个群体特别值得关注,那就是老年患者,他们早期认知功能下降和谵妄的风险增加。

如果老年CABG患者的这种早期功能障碍也转化为发生痴呆的长期高风险,对治疗方法的选择有直接影响。

哥德堡大学的KokWai Giang等人,基于以人群为基础的大型队列研究,探究了CABG患者和来自普通人群的匹配对照对象患痴呆症的长期风险,及其与年龄和性别的关系。并探究了CABG患者患痴呆症的独立预测因素。

他们纳入了1992-2015年瑞典所有CABG患者(n = 111,335),以及匹配的对照组(n = 222,396),并计算了全因性痴呆、血管性痴呆和阿尔茨海默病的调整危险比(aHR)。

他们发现,CABG患者与对照组患者发生全因性痴呆的风险没有差异(aHR 0.98)。

CABG患者<65岁和65~74岁的风险较高(aHR分别为1.29和1.08),≥75岁的患者风险较低(aHR 0.76)。女性<65岁者风险最高(aHR 1.64)。

总的来说,CABG患者与普通人群之间发生全因性痴呆的长期风险没有差异。与对照组相比,年轻患者的风险较高,而老年患者的风险较低。


原文出处:

Giang, K. W., Jeppsson, A., Karlsson, M., Hansson, E. C., Pivodic, A., Skoog, I., ... & Nielsen, S. J. (2021). The risk of dementia after coronary artery bypass grafting in relation to age and sex. _Alzheimer's & Dementia_.

 

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    2022-01-24 ms300

    学习

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1694783, encodeId=31af1694e835f, content=<a href='/topic/show?id=030551528ec' target=_blank style='color:#2F92EE;'>#心脏搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51528, encryptionId=030551528ec, topicName=心脏搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ba429754956, createdName=grace5710, createdTime=Sat Aug 07 16:46:14 CST 2021, time=2021-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1187702, encodeId=75df118e70239, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2716443372, createdName=ms300, createdTime=Mon Jan 24 14:22:22 CST 2022, time=2022-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663977, encodeId=f22816639e791, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Sat Aug 21 08:46:14 CST 2021, time=2021-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1717994, encodeId=37251e1799482, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Thu Mar 25 17:46:14 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950958, encodeId=d6ff950958ab, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200823/c4e49e572a9e473bab215760c091ca75/e612ea5c4b3140688a994c9c7fdded4d.jpg, createdBy=bb485311529, createdName=12548, createdTime=Thu Mar 25 11:16:31 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1316773, encodeId=8dfc1316e73fa, content=<a href='/topic/show?id=d3d0e121576' target=_blank style='color:#2F92EE;'>#痴呆风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71215, encryptionId=d3d0e121576, topicName=痴呆风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a98f453, createdName=pcw106, createdTime=Fri Mar 19 21:46:14 CST 2021, time=2021-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048743, encodeId=0c821048e434d, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Thu Mar 18 09:46:14 CST 2021, time=2021-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949173, encodeId=561c9491e3b1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8a6c5470392, createdName=ms8000001891656277, createdTime=Thu Mar 18 09:46:00 CST 2021, time=2021-03-18, status=1, ipAttribution=)]
    2021-03-25 12548

    学习了

    0

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    2021-03-18 junJUN

    老年人痴呆何药可用??

    0

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    2021-03-18 ms8000001891656277

    学习

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