长期使用β1受体阻滞剂对血管性痴呆患者认知功能的影响OA
Effects of long-term use of β1 blockers on cognitive function in patients with vascular dementia
目的 评估长期使用β1 受体阻滞剂对血管性痴呆患者认知功能的影响,并分析不同疾病阶段的疗效及共病依赖性.方法 回顾性纳入2020 年1 月至2025 年3 月确诊的240 例血管性痴呆患者,包括长期使用β1 受体阻滞剂(≥2 年)组(研究组)120 例和对照组120 例.通过电子病历系统收集基线数据(年龄、性别、共病、用药史)及临床痴呆评级量表(CDR)、痴呆评定量表(DRS)评分.采用t检验、χ2 检验、多元线性回归(调整混杂因素)及亚组分析(按痴呆分期、高血压分层)进行统计比较.结果 研究组与对照组在年龄、性别、受教育年限及基础疾病的差异均无统计学意义,具有良好的可比性.研究组的CDR评分明显低于对照组,DRS总分明显高于对照组(均P＜0.01).多变量分析结果显示,长期使用β1 受体阻滞剂与CDR评分降低呈负相关(β=-0.35,95%CI:-0.52～-0.18,P＜0.001);与DRS总分呈正相关(β=12.5,95%CI:8.2～16.8,P＜0.001).亚组分析结果显示,在轻度痴呆(CDR=1)的114 例患者中,研究组的CDR评分显著低于对照组(P＜0.01);在中度痴呆(CDR=2)的97 例患者中,两组间CDR评分的差异无统计学意义(P=0.07);在重度痴呆(CDR=3)的29 例患者中,两组间CDR评分的差异亦无统计学意义(P=0.85).此外,在合并高血压的199 例患者中,研究组的CDR评分明显低于对照组(P＜0.01).结论 长期β1 受体阻滞剂使用可改善血管性痴呆患者认知功能,尤其在疾病早期(CDR=1)及合并高血压人群中效果显著,提示其作为靶向干预措施的潜力,临床应优先考虑此类人群并把握治疗窗口期.
Objective To evaluate the impact of long-term β1 blocker use on cognitive function in patients with vascular dementia and analyze the efficacy concerning disease stage and comorbidity dependence.Methods Recruitment retrospectively included 240 cases of vascular dementia diagnosed between January 2020 and March 2025,including 120 cases in the long-term use of β1-receptor blockers(≥2 years)group(study group)and 120 cases in the control group.Baseline data(age,sex,comorbidities,medication history)and clinical dementia rating scale(CDR)and dementia rating scale(DRS)scores were collected through an electronic medical record system.Statistical comparisons were performed using t tests,χ2 tests,multivariable linear regression(with adjustments for confounding factors),and subgroup analyses(by dementia stage and hypertension stratification).Results The differences in age,gender,years of education,and underlying diseases between the study group and the control group had no statistically significant,showing good comparability.The CDR score of the study group was significantly lower than that of the control group,and the DRS total score was significantly higher than that of the control group(all P＜0.01).Multivariable analysis results showed that long-term use of β1 blockers was negatively correlated with CDR scores(β=-0.35,95%CI:-0.52--0.18,P＜0.001),while positively correlated with DRS total scores(β=12.5,95%CI:8.2-16.8,P＜0.001).Subgroup analysis results showed that among 114 patients with mild dementia(CDR=1),the CDR scores of the study group were significantly lower than those of the control group(P＜0.01);among 97 patients with moderate dementia(CDR=2),the difference in CDR scores between the two groups was not statistically significant(P=0.07);and among 29 patients with severe dementia(CDR=3),the difference in CDR scores between the two groups was also not statistically significant(P=0.85).In addition,among the 199 patients with hypertension,the CDR scores of the study group were significantly lower than those of the control group(P＜0.01).Conclusions Long-term use of β1 blockers can improve cognitive function in patients with vascular dementia,particularly in the early stages of the disease(CDR=1)and in those with hypertension,suggesting their potential as a targeted intervention.Clinicians should prioritize these populations and seize the therapeutic window.
高晓红;王玉梅;李瑾
733000 武威市人民医院神经内科733000 武威市人民医院神经内科733000 武威市人民医院神经内科
医药卫生
血管性痴呆β1受体阻滞剂风险痴呆高血压
vascular dementiaβ1 blockersriskdementiahypertension
《临床神经病学杂志》 2026 (2)
86-89,4
武威市科技计划(WW24B01SF055)
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