糖尿病反复低血糖与认知功能障碍的研究

目的：探讨2型糖尿病患者反复低血糖与认知功能之间的关系。方法选取2013年1月至2015年1月在我院内分泌科的2型糖尿病患者120例作为研究对象,采用随机数字表发将患者随机分为观察组和对照组。将伴轻度认知功能障碍的2型糖尿病患者为观察组(62例),无轻度认知功能障碍的2型糖尿病患者为对照组(58例)。两组患者应用一般资料调查问卷、蒙特利尔认知评估量表对其进行问卷调查,同时检测两组患者的糖化血红蛋白( HbA1c)、空腹血糖( FBS)、收缩压(SBP)、舒张压(DBP)、高敏C反应蛋白(hs-CRP),并使用动态血糖监测并记录低血糖发生率。结果观察组的HbA1c (6.25±1.51)、FBS(6.23±1.17)、高血压病程(5.55±2.78)、糖尿病病程(6.86±4.15)、低糖发生率(48.34%)、SBP(152.21±17.62)、hs-CRP(6.05±2.16)与对照组比较[(7.65±2.45)、(7.27±1.62)、(3.71±1.96)、(5.11±3.74)、23.06%、(142.11±10.23)、(6.21±2.62)],差异有统计学意义(P<0.05),对照组的MoCA评分总分及其视空间结构、注意和延迟记忆维度得分显著低于观察组,差异有统计学意义(P<0.05)；经pearson相关分析显示,MoCA评分总分与HbA1c、FBS、SBP、高血压病程、糖尿病病程、hs-CRP、低血糖发生事件存在不同程度的负相关(P<0.05)。结论糖尿病认知功能障碍的危险因素,2型糖尿病患者反复低血糖会使认知功受损,因此在临床中应注意对2型糖尿病患者进行早期合理的干预治疗来延缓认知功能减退的发生。

The Study of Diabetes and Hypoglycemia and Cognitive Dysfunction

Objective To study the patients with type 2 diabetes and hypoglycemia and the relationship between the cognitive function. Methods between January 2013 and January 2013 in our hospital, 120 patients with type 2 diabetes mellitus in endocrinol-ogy as the research object, USES the random number table patients were randomly divided into observation group and control group. With mild cognitive dysfunction in patients with type 2 diabetes as the observation group (62 cases), without a mild cognitive dysfunc-tion in patients with type 2 diabetes for the control group (58 cases). Two groups of patients with application of general data question-naire, Montreal cognitive assessment scale on the questionnaire survey, at the same time detection of two groups of patients of glycated hemoglobin (HbA1c), fasting blood sugar (FBS), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-sensitivity c-reactive protein (hs-CRP), incidence of hypoglycemia and use dynamic blood sugar monitoring and recording. Results Observa-tion group HbA1c (6. 25±1. 51), FBS (6. 23±1. 17), hypertension duration (5. 55±2. 78), (6. 86±4. 15), the duration of diabetes incidence in sugar (48. 34%), SBP, (152. 21-17. 62), the hs CRP (6. 05±2. 16) compared with control group[(7. 65±2. 45), (7. 27±1. 62),(3. 71±1. 96),(5. 11±3. 74),23. 06%,(142. 11±10. 23),(6. 21±2. 62)], the difference was statistically signifi-cant (P<0. 05), the control group the MoCA score and total score of visual space structure dimension, attention and delayed memory score was significantly lower than group, the difference was statistically significant (P< 0. 05); By the Pearson correlation analysis showed that MoCA score and total score HbA1c, FBS, SBP, hypertension, diabetes duration, duration of the hs CRP, hypoglycemia events exist different degree of negative correlation (P<0. 05) . Conclusion The risk factors of diabetic cognitive dysfunction, in pa-tients with type 2 diabetes and hypoglycemia can make the impaired cognitive function, so should be paid attention to in clinical rea-sonable early intervention in patients with type 2 diabetes treatment to delay the onset of cognitive decline.