r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2023-28-3-5-13r-n-j-426Research ArticleОБЗОРLITERATURE REVIEWКогнитивные нарушения у пациентов с хронической обструктивной болезнью легкихСognitive impairment in patients with chronic obstructive pulmonary diseasehttps://orcid.org/0009-0005-1148-9205КопыловаА. П.KopylovaA. P.

Москва

Moscow

anna-kopylova-12@mail.ruhttps://orcid.org/0000-0002-8447-3264ЗахаровВ. В.ZakharovV. V.

Захаров Владимир Владимирович

Москва

Vladimir Vladimirovich Zakharov

Moscow

zakharovenator@gmail.comhttps://orcid.org/0000-0002-0834-4030ВахнинаН. В.VakhninaN. V.

Москва

Moscow

nvakhnona71@mail.ruПервый Московский государственный медицинский университет им. И. М. Сеченова (Сеченовский Университет)РоссияI. M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202319072023283513Copyright © Копылова А.П., Захаров В.В., Вахнина Н.В., 20232023Копылова А.П., Захаров В.В., Вахнина Н.В.Kopylova A.P., Zakharov V.V., Vakhnina N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/426

Проведен систематический обзор 23 оригинальных исследований, опубликованных с 2010 по 2022 г., в которых в общей сложности приняло участие 168 тыс. человек, из них 48 тыс. пациентов с хронической обструктивной болезнью легких (ХОБЛ) в возрасте от 45 до 93 лет.

Результаты

Результаты. Распространенность когнитивных нарушений (КН) у пациентов с ХОБЛ варьирует от 6 до 63%. Пациенты с ХОБЛ имеют достоверно более высокий риск развития умеренных КН (отношение рисков (ОР) от 1,1 до 1,9; отношение шансов (ОШ) от 1,4 до 2,4) и деменции (ОР от 1,3 до 1,9; ОШ = 1,2). Риск возникновения когнитивной дисфункции возрастает со снижением значений объема форсированного выдоха за первую секунду в процентах от должного (ОФВ1%) (ОШ = 1,34), парциального давления кислорода в артериальной крови (PaO2) (ОШ = 5,45), сатурации кислорода артериальной крови (SaO2) и повышением значений парциального давления углекислого газа в артериальной крови (PaCO2). Имеется прямая взаимосвязь между ОФВ1% и показателем краткой шкалы оценки психического статуса (Mini-Mental State Examination, (MMSE)) (p < 0,0001) и обратная зависимость между тяжестью ХОБЛ и показателем MMSE (p < 0,0001). Показатели MMSE коррелируют с ОФВ1% (r = 0,46; p < 0,01) и PaO2 (r = 0,43; p < 0,05).

Заключение

Заключение. Имеющиеся данные подтверждают связь ХОБЛ с повышенным риском возникновения и прогрессирования КН. Обсуждается, что это может быть обусловлено неблагоприятным течением сопутствующих сосудистых и нейродегенеративных заболеваний на фоне хронической гипоксии.

We conducted a systematic review of 23 original studies published from 2010 to 2022, which participated a total of 168 thousand people, including 48 thousand patients with chronic obstructive pulmonary disease (COPD) aged 45 to 93 years.

Results

Results. The prevalence of cognitive impairment (CI) in patients with COPD varies from 6 to 63%. COPD patients have a higher risk of developing mild CI (HR from 1.1 to 1.9; OR from 1.4 to 2.4) and dementia (HR from 1.3 to 1.9; OR = 1.2). The risk of cognitive dysfunction increases along with a decrease in the values of forced expiratory volume in one second as a percentage of its expected value (FEV1%) (OR = 1.34), arterial oxygen partial pressure (PaO2) (OR = 5.45), oxygen saturation (SaO2) and an increase in the level of arterial carbon dioxide partial pressure (PaCO2). There is a significant direct relationship between FEV1% and Mini-Mental State Examination (MMSE) (p < 0.0001) and an inverse relationship between COPD severity and MMSE (p < 0.0001). The MMSE score is correlated with FEV1% (r = 0.46, p < 0.01) and PaO2 (r = 0.43, p < 0.05).

Conclusion

Conclusion. The available data confirm the association of COPD with an increased risk of occurrence and progression of CI. It is discussed that this is due to the unfavorable course of concomitant vascular and neurodegenerative diseases against the background of chronic hypoxia.

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The authors declare that there are no conflicts of interest present.