慢性心衰合并认知障碍患者用药情况及其与认知功能相关性的倾向性评分匹配分析

The Tendency Score Matching Analysis of Medication Status in Chronic HF Patients with Cognitive Impairment and Their Correlation with Cognitive Function

摘要: 目的：基于倾向性评分匹配分析慢性心力衰竭(心衰)合并认知障碍患者用药情况及其与认知功能相关性。方法：选取2024年1月至2024年12月青岛大学附属医院心内科连续入院的慢性心衰患者136例作为研究对象，根据患者的认知功能评估结果，将患者分为慢性心衰合并认知障碍组(CI组) 54例和慢性心衰认知功能正常组(n-CI组) 82例。在基线分组的基础上，以患者的年龄、性别、文化程度等基本信息和合并症等混杂因素为匹配条件，对两组被试进行1:1倾向性评分匹配，匹配后CI组及n-CI组各42名。比较匹配后两组患者的用药情况，以是否合并认知障碍为因变量进行多元线性回归分析评价慢性心衰合并认知障碍患者用药情况与认知功能的相关性。结果：两组倾向性匹配前年龄、心衰病程、受教育年限、合并糖尿病对比差异有统计学意义(P < 0.05)，倾向性匹配后共42对匹配成功，两组一般资料对比无统计学差异(P > 0.05)；CI组盐皮质激素受体拮抗剂(MRA)、纳–葡萄糖共转运蛋白2抑制剂(SGLT2i)、纳–葡萄糖共转运蛋白2抑制剂(SGLT2i)使用率较n-CI组低(P < 0.05)；以认知功能评分为因变量，BB、MRA、血管紧张素受体脑啡肽酶抑制剂(ARNI)/血管紧张素II受体拮抗剂(ARB)/血管紧张素转换酶抑制剂(ACEI)、SGLT2i作为自变量进行多元线性回归分析，结果显示，MRA、SGLT2i与认知功能呈正相关(β = 1.856; β = 1.704)。结论：在慢性心衰合并认知功能障碍患者的治疗中，SGLT2i和MRA的使用率相对较低，SGLT2i、MRA的使用与认知功能有关。

Abstract: Objective: The medication status and its correlation with cognitive function of patients with chronic heart failure (CHF) combined with cognitive impairment were analyzed by tendency score matching. Methods: A total of 136 patients with chronic heart failure who were admitted to the Department of Cardiology at Qingdao University Affiliated Hospital from January to December 2024 were selected as the study subjects. Based on their cognitive function assessments, the patients were divided into two groups: 54 in the Chronic Heart Failure with Cognitive Impairment (CI) group and 82 in the Chronic Heart Failure with Normal Cognitive Function (n-CI) group. Based on the baseline grouping, participants were matched 1:1 for two groups using patient age, gender, education level, and comorbidities as matching criteria. After matching, there were 42 participants in each group: CI and n-CI. The medication use of the two groups was compared, with comorbid cognitive impairment as the dependent variable, to evaluate the relationship between medication use and cognitive function in patients with chronic heart failure and cognitive impairment using multiple linear regression analysis. Results: There were statistically significant differences in age, duration of heart failure, years of education and combined diabetes before propensity matching between the two groups (P < 0.05), after tendency matching, a total of 42 pairs were successfully matched, and there was no statistical difference in the comparison of general data between the two groups (P > 0.05); The use rate of mineralocorticoid receptor antagonists (MRA), sodium-glucose cotransporter 2 inhibitors (SGLT2i), and angiotensin-converting enzyme inhibitors (ACEI) in the CI group was significantly lower than that in the n-CI group (P < 0.05). Using cognitive function scores as the dependent variable, and BB, MRA, ARNI/ARB/ACEI, SGLT2i as independent variables, a multiple linear regression analysis was conducted. The results showed that MRA and SGLT2i were positively correlated with cognitive function (β = 1.856; β = 1.704). Conclusion: The use of SGLT2i and MRA is relatively low in patients with chronic heart failure combined with cognitive dysfunction, and the use of SGLT2i and MRA is associated with cognitive function.