2024 年第 6 期 第 0 卷

冠心病合并认知障碍的生理机制和行为心理机制研究进展

Research progress on the physiological and behavioral mechanisms of coronary atherosclerotic heart disease combined with cognitive impairment

作者：张佳宜1韩红亚1刘晓丽1马涵英2王琛茜1唐琛1

英文作者：Zhang Jiayi1 Han Hongya1 Liu Xiaoli1 Ma Hanying2 Wang Chenxi1 Tang Chen1

单位：1首都医科大学附属北京安贞医院老年心血管病中心，北京100029；2首都医科大学附属北京安贞医院全科医疗科，北京100029

英文单位：1Geriatric Cardiovascular Genter Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of General Medicine Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；认知障碍；发病机制

英文关键词：Coronaryatheroscleroticheartdisease；Cognitiveimpairment；Pathogenesis

• 摘要：

• 随着人口老龄化问题日益加剧，冠心病（冠状动脉粥样硬化性心脏病）合并认知障碍逐渐受到关注。流行病学数据表明，冠心病与认知障碍患病风险间存在明显正相关，患者表现出更差的认知能力，且合并冠心病的认知障碍患者认知功能下降速度更快。冠心病合并认知障碍不仅严重损害患者身心健康，也加重了社会负担。冠心病合并认知障碍成因复杂，发病机制多样，包括血管内皮功能障碍、胆固醇-25-羟化酶介导免疫炎症反应、血小板过度激活神经酰胺等生理机制，以及受教育水平、心脏有创手术、感知活动能力下降等行为心理机制。本文旨在对冠心病合并认知障碍的生理和行为心理机制最新研究进展进行综述，为冠心病合并认知障碍的临床诊治及预防提供思路。

• With the aggravation of population aging, coronary atherosclerotic heart disease (CHD) combined with cognitive impairment has gradually attracted attention.Epidemiological data show that there is a significant positive correlation between CHD and the risk of cognitive impairment. Patients with CHD show worse cognitive ability, and patients with cognitive impairment combined with CHD have a faster rate of cognitive decline. CHD combined with cognitive impairment not only seriously damages the physical and mental health of patients, but also increases the social burden.The causes of CHD combined with cognitive impairment are complex and the pathogenesis is diverse, including physiological mechanisms such as vascular endothelial dysfunction, cholesterol-25-hydroxylase mediated immune inflammation, and excessive activation of ceramide by platelets, as well as behavioral and psychological mechanisms such as education level, cardiac invasive surgery, and decreased perceived activity ability.This article aims to review the latest research progress on the physiological and behavioral psychological mechanisms of CHD combined with cognitive impairment, so as to provide ideas for the clinical diagnosis, treatment and prevention of CHD combined with cognitive impairment.