HIV/AIDS患者主观与客观认知障碍现状及影响因素分析

doi:10.19871/j.cnki.xfcrbzz.2025.03.008

摘要/Abstract

摘要： 目的联合应用两种神经认知评估量表,调查并分析HIV/AIDS患者主观与客观认知障碍的发生现状及影响因素,为临床早期筛查和个性化干预提供参考依据。方法选取2024年5月至7月深圳市第三人民医院住院的175例HIV/AIDS患者,使用一般资料调查表、蒙特利尔认知评估（Montreal cognitive assessment,MoCA）量表、感知缺陷问卷（perceptual deficit questionnaire,PDQ）进行调查,采用多元线性回归和二元Logistic回归分析患者主观和客观神经认知障碍的影响因素。结果 175例HIV/AIDS患者中,经PDQ检出存在主观认知下降者65例,占比37.1%,PDQ得分为14.0（6.0,26.0）分;经MoCA量表检出98例患者存在客观认知障碍,占比56.0%,MoCA量表得分为26.0（22.0,28.0）分。不同性别、年龄分层、是否失眠、不同睡眠质量、不同睡眠持续时间、不同服药依从性患者主观认知障碍PDQ评分差异有统计学意义。不同性别、年龄、婚姻状况、付费方式、受教育程度、居住地、月收入、腰围、住院天数、抗病毒治疗年限、合并症数量、合并HCV感染HIV/ARDS患者客观认知障碍MoCA量表评分差异有统计学意义。多因素Logistic回归分析结果显示,性别、睡眠质量和服药依从性是HIV/AIDS患者主观认知下降的影响因素;受教育程度和合并丙型肝炎感染为客观认知障碍的影响因素。结论 HIV/AIDS患者神经认知障碍发生率高,女性、受教育程度较低者、合并丙型肝炎感染者、服药依从性差者及睡眠质量差者是认知障碍的高危人群。临床医护人员对于高危人群应早期筛查并给予循证干预,以期预防或延缓神经认知障碍的发生发展。

关键词: 人类免疫缺陷病毒, 获得性免疫缺陷综合征, 主观认知下降, 认知障碍, HIV相关神经认知障碍, 影响因素

Abstract: Objective To investigate the occurrence and influencing factors of both subjective and objective cognitive impairment in HIV/AIDS patients by combining two neurocognitive assessment scales, and to provide reference for early clinical screening and personalized intervention. Method 175 patients with HIV/AIDS hospitalized in Shenzhen Third People's Hospital from May to July 2024 were selected and investigated by general data questionnaire, Montreal Cognitive Assessment Scale(MoCA) and perceptual deficit questionnaire(PDQ). Multiple linear regression and binary Logistic regression were used to analyze the factors affecting subjective and objective neurocognitive impairment. Result Among 175 HIV/AIDS patients, 65 cases (37.1%) were found to have subjective cognitive decline by perception deficit questionnaire. PDQ scores were 14.0 (6.0, 26.0). Objectivecognitive impairment was detected in 98 patients with Montreal cognitive scale, accounting for 56.0%, and MoCA score was 26.0 (22.0, 28.0) points. The single factor results showed that the scores of PDQ were correlated with gender, age, insomnia, sleep quality, sleep duration and medication compliance. The scores of MoCA were correlated with gender, age, marital status, payment mode, education level, residence, monthly income, waist circumference, length of hospital stay, years of antiviral treatment, number of comorbidities, and coinfection with Hepatitis C virus (HCV). The results of multiple factors showed that gender, sleep quality and medication compliance were the factors affecting subjective cognitive decline in HIV/AIDS patients. Educational attainment and coinfection with HCV were risk factors for objective cognitive impairment. Conclusion The incidence of neurocognitive impairment is high in HIV/AIDS patients. Women, those with lower education, those with HCV infection, those with poor medication compliance and those with poor sleep quality are at high-risk for cognitive impairment. Early screening and evidence-based intervention should be given to high-risk groups in order to prevent or delay the occurrence and development of neurocognitive disorders.

Key words: Human immunodeficiency virus, Acquired immune deficiency syndrome, Subjective cognitive decline, Cognitive impairment, HIV-associated neurocognitive disorders, Influencing factors

中图分类号:

R47.55

李孟君, 陈敬芳, 袁静, 唐芳, 阮淑金, 孟婷, 詹翠霞. HIV/AIDS患者主观与客观认知障碍现状及影响因素分析[J]. 新发传染病电子杂志, 2025, 10(3): 47-52.

Li Mengjun, Chen Jingfang, Yuan Jing, Tang Fang, Ruan Shujin, Meng Ting, Zhan Cuixia. Analysis of prevalence and influencing factors of subjective cognition and objective cognitive impairment in HIV/AIDS patients[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(3): 47-52.

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