2型糖尿病患者认知功能障碍危险因素的临床研究

目的研究老年2型糖尿病患者认知功能障碍的危险因素，为早期预防和治疗2型糖尿病患者认知功能障碍提供临床依据。方法选择临床已确诊2型糖尿病的患者211例。采用蒙特利尔认知评估量表（MOCA）中文版对所有入选对象进行认知功能评估，并根据其结果MOCA评分结果分为认知功能正常组（NC组）和认知功能障碍组（CI组）。详细记录其性别、年龄、受教育程度、工作性质、患糖尿病年限、是否合并高血压，并测定其体重指数及糖化血红蛋白水平等。结果2型糖尿病认知功能障碍组与认知功能正常组在年龄、受教育程度、工作性质、体重指数和糖化血红蛋白水平之间存在统计学差异（P〈0．05）。多因素逐步回归分析发现年龄、受教育程度及糖化血红蛋白水平是MOCA评分的独立危险因素。结论高龄、高体重指数和高糖化血红蛋白是2型糖尿病患者的认知功能障碍的危险因素。受教育程度高是2型糖尿病认知功能障碍的保护因素。有效控制血糖、体重、增加受教育的程度等可能有助于预防或延缓2型糖尿病患者认知功能障碍的发生。

A clinical research of risk factors in type 2 diabetic patients with cognitive impairment

Objective To study the risk factors in type 2 diabetic patients with cognitive impairment and provide clini- cal evidences for early prevention and treatment of type 2 diabetic patients with cognitive impairment. Methods A to- tal of 211 cases of patients with type 2 diabetes were selected and their cognitive function had been assessed with the Chinese version of Montreal Cognitive Assessment （MOCA）. Based on the MOCA scores, they were divided into the cognitive impairment group （CI） and the normal group （NC）. Their gender, age, the level of education , the nature of the work, hypertension, body mass index, g]ycohemoglobin were recorded. Results There was a statistically signifi- cant difference （P 〈 0.05） between the two groups in age, the level of education, body mass index, and glycohemoglobin. Multiple stepwise regression analysis showed that age, the level of education and the level of glycohemoglobin were in- dependent risk factors for MOCA scores. Conclusion Elderly, high body mass index , and high glycated hemoglobin are risk factors for cognitive impairment in type 2 diabetic patients. Highly educated is a protective factor for cognitive impairment in type 2 diabetic patients. Effective controlling of blood glucose , body weight, and increasing the level of education may contribute to preventing or delaying the occurrence of cognitive impairment in type 2 diabetic patients.