老年2型糖尿病合并高血压患者认知功能改变特点及危险因素研究

目的分析老年2型糖尿病合并高血压患者认知功能的改变特点和相关危险因素。方法选取2016年9月—2017年6月在上海市普陀区真如镇社区卫生服务中心门诊和住院诊治的225例老年患者为研究对象,其中单纯糖尿病患者78例为A组,单纯高血压患者84例为B组,糖尿病合并高血压患者63例为C组,收集患者的一般资料,测定生化指标。采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)、简易智能状态量表(Mini-Mental State Examination,MMSE)对三组患者进行认知功能评价,了解患者认知功能的改变特点。根据Mo CA评分,将225例患者筛选出轻度认知障碍(MCI)组86例和非MCI组139例,分析两组患者认知功能的改变特点和相关危险因素。结果 C组Mo CA评分明显低于A组、B组,C组命名、注意力明显低于B组,三组之间抽象思维差异有统计学意义;C组患者MCI发生率明显高于A组和B组(P0.05)。MCI组与非MCI组患者在年龄、受教育年限、FPG、Hb A1c和HCY的差异有统计学意义(P0.05)。多元回归分析结果显示:年龄、HCY和Hb A1c是老年患者发生认知功能损害的危险因素,受教育年限是发生认知功能损害的保护因素(P0.05)。结论老年2型糖尿病合并高血压患者MCI发生率明显高于单纯糖尿病组和单纯高血压组。

Characteristics and Risk Factors of Cognitive Function in elderly Patients with Type 2 diabetes Mellitus Complicated with Hypertension

OBJECTIVE To investigate the characteristics of cognitive function in elderly patients with type 2 diabetes mellitus and hypertension, and to analyze related risk factors. METHODS A total of 225 elderly patients admitted in our department from September 2016 to June 2017. They were divided into simple diabetes mellitus as A group (n=78),simple hypertension as B group(n=84), diabetic patients with hypertension as C group(n=63). General data of patients were collected and biochemical indexes were measured. The Montreal cognitive assessment scale (MoCA), Mini-Mental State Examination (MMSE) for the evaluation of cognitive function of three groups of patients.To investigate the change of cognitive function in the three groups. According to the MoCA score, 225 patients were divided into MCI group(n=86) and non MCI groups(n=139). The characteristics of cognitive function change and related risk factors were analyzed in the two groups.RESULTS Comparison of three groups of patients with cognitive function score, MoCA score in C group was significantly lower than that of A group, B group.Naming, attention in group C was significantly lower in group B.There was statistical significance of abstract thinking in the three groups. The incidence rate of MCI in C group was significantly higher than that of A group and B group (P<0.05). The difference between the MCI group and the non MCI group in age, length of education, FPG, HbA1c, HCY was statistically significant (P<0.05). Multiple regression analysis showed that age, HCY and HbA1c were risk factors of cognitive impairment in elderly patients, and the duration of education was the protective factor of cognitive impairment. CONCLUSIONS The incidence of MCI in elderly patients with type 2 diabetes mellitus and hypertension is higher than that of simple diabetes group and simple hypertension group.