慢性阻塞性肺疾病患者認知功能異常之影響因子探討

背景:慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD) 是一種漸進性，伴有肺臟及呼吸道的慢性發炎性肺疾病，好發於中老年人，因病理變化不可逆、病程漫長，失能年數逐年攀升。在台灣，根據衛生福利部資料，COPD 造成70歲以下生命年數損失約10.6年，對中老年人的健康及生活的衝擊是可以預見的。COPD 特徵為持續的呼氣氣流受阻、慢性發炎導致呼吸困難、低血氧症等，造成腦部含氧量減少，可能導致 COPD 病患認知功能異常情產生。目的:目前影響 COPD 病患認知功能異常的因子尚不清楚，因此，根據文獻查證得到15種可能影響 COPD 病患認知功能異常的因子，藉由本研究收集 COPD 病人(N=80) 且分類為社會人口學特性、疾病特性、共病症、主觀呼吸困難程度、低血氧狀態、憂鬱狀態找出 COPD 病人認知功能異常的影響因子。結果:研究資料經統計80位 COPD 病人中，認知功能以短期記憶和思考流暢度方面分數較差。另外，將認知功能分數依照教育程度以及男女性別切斷分數得認知功能正常有70位，認知功能異常有10位。經由認知功能與各變項進行羅吉式複迴歸分析，結果發現影響 COPD 病人認知有年齡、低血氧狀態、和憂鬱狀態。結論/實務應用: 在本研究中探討15種影響 COPD 病人之認知功能因子，其中以年齡、教育程度、低血氧狀態、憂鬱狀態與認知功能異常有相關性。另外，在本研究中發現到 CDPD患者之憂鬱狀態也是使認知功能低下的重要影響因子。因此，對於了解本研究 CDPD患者而言，評估其認知功能是否異常不僅需考量其疾病特性也需要注意其憂鬱狀態。期望透過本研究結果資料能了解認知異常的影響因子，可幫助在臨床工作中觀察有這些影響因子的患者，將可能早期發現患者是否出現認知缺損、提供早期介入計畫。

關鍵字

慢性阻塞性肺疾病；呼吸困難；低血氧；認知功能

並列摘要

Background: COPD is a chronic inflammation disease that occurs at lung and respiratory tract. It often affects elders and is irreversible.The course of disease often takes years as the disability years increases annually. According to the Ministry of Health and Welfare in Taiwan, COPD decreases 10.6 years of lifespan for people under 70 and has great influences on the elders’ life and health. The characteristics of COPD are continuous respiratory flow obstruction, hypoxemia and chronic inflammation induced respiratory difficulties, which may decrease oxygen concentrations in the brain as well as the patient’s cognitive functions. Aims: Until now, risk factor that affects cognitive functions in patients suffering from COPD is still unclear. This study obtained data from COPD patients (N=80) and examined effects of 15 possible risk factors including diseases, comorbidities, hypoxemic state, objective respiratory difficulties, depressions and demography on their cognitive functions. Results: After evaluation of 80 COPD patients, cognitive function of short term memory and thinking fluency showed decreased performances. Among them, 70 came up with normal and the rest 10 patients showed abnormal cognitive functions based on their gender and education level. Results of multiple logistic regression analysis showed COPD patient’s cognitive level are affected by age, hypoxemic state and depression. Conclusion: In COPD patients, age, education level, hypoxemic state and depression are associated with their cognitive functions. Therefore, not only the state of their disease should be taken into consideration but also their mood in terms of depression when evaluate their cognitive function. Results of this study provide clinical medical staffs reference to detect risk factors for assessing cognitive function and would be able to provide early medical interventions in COPD patients.

並列關鍵字

Chronic obstructive pulmonary disease ； Dyspnea ； Hypoxemia ； Cognitive function

參考文獻

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慢性阻塞性肺疾病患者認知功能異常之影響因子探討

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