| bjective: to evaluate the cognitive function of middle-aged and elderly patients with non-valvular atrial fibrillation(NAF)and to investigate the mild cognitive impairment(MCI)in middle-aged and elderly patients with non-valvular atrial fibrillation.To provide clinical evidence for early intervention in middle and old patients with non-valvular atrial fibrillation and to reduce the risk of cognitive dysfunction and dementia.Methods : from July 2017 to December 2018,elderly patients with atrial fibrillation in our hospital(Chengdu No.3 people’s Hospital)were selected as observation group and sinus rhythm patients in our hospital as control group.Hamilton anxiety scale(HAMA)was used.and Hamilton Depression scale(HAMD)exclude anxiety and depression,mini-mental state scale(MMSE,using Zhang Mingyuan scale),Montreal Cognitive scale(MOCA,Changsha version)to assess the overall cognitive function of patients with atrial fibrillation,the ability of daily living(ADL)to assess the ability of daily life,the Clock Drawing Task(CDT),the shape trails test(STT-AB),Stroop color words test(SCWT)was used to evaluate the executive function of patients with atrial fibrillation.To compare the difference of cognitive function between the two groups.Results:(1)203 patients with atrial fibrillation(observation group)and 183 patients with sinus rhythm(control group)were included.The mean age of patients with atrial fibrillation was(67.3 ±7.3)years,and that of patients with sinus rhythm was(66.9 ±7.6)years.There were 127(62.5%)and 47(25.6%)patients with lacunar cerebral infarction in the AF group than in the sinus rhythm group.The atrial fibrillation group was significantly higher than the sinus rhythm group,and the difference was statistically significant.Homocysteine was(15.00 ±4.40)in patients with atrial fibrillation and(13.52 ±3.39)in patients with sinus rhythm.(2)overall cognitive function score: compared with sinus rhythm group,the MMSE score of AF group was(27.56 ±1.83),(29.42 ±0.78),and the MOCA score was(24.14 ±3.42),(28.68 ±1.46).There is a statistical difference.The overall cognitive function score of patients with atrial fibrillation was significantly lower than that of sinus rhythm group.(3)Cognitive domain score: the memory scores of atrial fibrillation group were(8.6 ±1.57)and(10.28 ±0.95),respectively.The scores of attention and computational power were(9.5 ±0.94)and(10.62 ±0.61),respectively.Language scores were(3.97 ±0.94)and(3.97 ±0.94),respectively.Visual space and execution were(6.13 ±2.85)and(9.16 ±1.19),respectively.The scores of abstract thinking ability were(1.91 ±0.33)and(2.00 ±0.00)respectively.The orientation scores were(15.8 ±0.80)and(16.00 ±0.00),respectively.The score of atrial fibrillation was significantly lower in patients with atrial fibrillation than that in patients with sinus rhythm,and the difference was statistically significant.(4)score of executive function: compared with sinus rhythm group,the score of clock drawing test in AF group was(2.20 ±1.05),(2.78 ±0.41),there was statistical difference.The duration of STT-A was(106.2 ±68.27)seconds,(53.40 ±15.78)seconds,and the arrival number of one minute was(17.76 ±6.07)and(23.45 ±3.76)respectively.The duration of STT-B was(294.51 ±156.58)seconds,(161.28 ±14.96)seconds,(7.03 ±3.86)and(8.30 ±3.53)respectively.The time of card A was(36.39 ±12.52)seconds and(49.9 ±0.28)seconds,respectively.Card B took(55.71 ±14.37)seconds and(48.43 ±1.45)seconds,respectively.The C time of the card was(108.18 ±36.51)seconds and(60.22 ±31.19)seconds,respectively.The results showed that the difference was statistically significant.(5)there were 70 cases of persistent atrial fibrillation,103 cases of paroxysmal atrial fibrillation and 30 cases of permanent atrial fibrillation.there was no significant difference in cognitive function among the three groups.(6)the results of Logistic regression analysis showed that higher education level was the protective factor of cognitive function,and higher BMI and HCY,with diabetes were risk factors of cognitive function in patients with AF.Conclusion: 1.The memory,attention and calculation,language,visual space and executive ability,abstract thinking ability and orientation of the patients with atrial fibrillation were significantly lower than those of the patients with sinus rhythm.2.The executive function of patients with atrial fibrillation was significantly lower than that of patients with sinus rhythm.3.There was no significant difference in cognitive function between paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation.4.Age and education level are the related factors of cognitive function evaluation.Higher education level was the protective factor of cognitive function,and higher BMI and HCY,with diabetes were risk factors of cognitive function in patients with atrial fibrillation.bjective: To investigate the changes of cognitive function in patients with non-valvular atrial fibrillation before and after radiofrequency ablation(AFCA)under general anesthesia,and to provide a clinical basis for improving the comprehensive treatment of patients with atrial fibrillation.Methods : From July 2017 to July 2018,52 middle-aged and elderly patients with atrial fibrillation received AFCA in our hospital(Chengdu No.3 people’s Hospital).Anesthesia was performed under general anesthesia.(MMSE),Montreal Cognitive scale(MOCA),bell drawing test(CDT),was detected before and after AFCA.STT-AB),Stroop Color word Test(SCWT)and Daily living ability(ADL).Results: Cognitive function score(MOCA)was 24(22 / 26)and MOCA was 25(23 / 27)3 days after operation in patients with atrial fibrillation.The postoperative MOCA score was higher than that before operation.The score of MOCA was 24.5(23 / 26)at 3 months postoperatively,which was slightly higher than that before operation.In cognitive domain EF,STT-AB: STT-A took 74.5(61.5/90)seconds before operation and 77(63.25/77)seconds after operation.STT-B took 209(178/296)seconds before operation and 239(189.25/280)seconds on 3 days after operation.Stroop color word test showed that A card was time-consuming(32(28/38)seconds before operation and 35.5(28.25 / 39)seconds on 3 days after operation.The time of B card was 50.5(45/ 58)seconds before operation and 56(46.25 / 62.25)seconds on 3 days after operation.Three months after operation,the STT-AB time was 69.5(60.75/90.75)seconds,and the SCWT suggested A card time was 33(28.75 /38)seconds.B card 51(45/58.25)seconds,C card 96.5(77.75/108.25)seconds.There was no significant difference between 3 months after operation and before operation.Conclusion:(1)the total cognitive function was not affected in the short term after AFCA,only a part of EF was slightly decreased,and the ability of daily living was not affected.(2)the general anesthesia style during AFCA had no significant effect on the overall cognitive function of the patients in a short period of time. |
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