中老年2型糖尿病认知功能损害及其相关危险因素分析

目的:了解本地区中老年糖尿病认知功能损害特点及其相关危险因素。方法:选择本地区>55岁2型糖尿病患者,应用简易智能精神检查量表(MMSE)筛查,>25分者入选,入选者120例,与之相匹配的非糖尿病对照组60例。两组分别测定快速词汇测验、词汇测验、相似性测验、数字广度测验、填图和木块图测验。异常结果与血压、空腹血糖、糖化血红蛋白和血脂进行相关回归分析。结果:糖尿病组与对照组相比,快速词汇、填图和木块图三项检查差异显著,糖尿病组得分低于对照组(P均<0.05)。经逐步回归分析,快速词汇与年龄、收缩压呈显著的负相关(P<0.01)。木块图与年龄、糖化血红蛋白呈显著的负相关(P<0.01)。而其他方面的差异均无统计学意义。糖尿病有并发症组数字广度和填图得分显著低于无并发症组,糖尿病组吸烟者在相似性、数字广度(倒)得分明显低于不吸烟或曾经吸烟者(P<0.05)。结论:本地区中老年糖尿病认知功能损害以视觉辨认能力和视觉空间认知损害为突出。糖尿病血糖控制情况、高血压、血管病变、年龄老化因素和吸烟均参与了认知功能减退的进程。慢性高血糖是损害认知功能的独立危险因素。

Clinical Research of Cognitive Function in Middle Aged and Older People with Type 2 Diabetes Mellitus and Analysis of Risk Factors in It

Objective To investigate the characteristics of diabetes correlated cognitive impairment and its relative risk factors in this district＇s crowd. Methods Two hundred middle aged and older diabetic patients received mental state test.A total of 120 type 2 Diabetes〉25 score and 60 non-diabetes control Objects were recruited.Rapid verbal retrieve and vocabulary test,similarly,digit span （forward, back）,looking for error and block design were examined.Correlativity and step regression analysis was used to identify demographic and biomedical variables associated with cognitive dysfunction. Results The rapid verbal retrieve,looking for error and block design scale were significantly lower in diabetic group than in control group（P〈0. 05）.The rapid verbal retrieve scale was under the influence of age and systolic blood pressure（P〈0.01）.The block design scale was relative to age and glycosylated hemoglobin （P〈0.01）.There was no difference between two groups in the other tests.The digit span and Looking for error scale were significantly lower in diabetic group with complications than those without complications （P〈0.05）. In diabetic group,Similarly,digit span （back）scale were significantly lower in current-smoking than no-smoking or ever-smoking （P〈0.05）.Conclusion The course of cognitive function decrease in diabetes may be concerned with hyperglycemia, hypertension,vascular changes,aging in the brain and smoking.Chronic hyperglycemia is an independent risk factor in cognitive impairment.