糖尿病患者认知功能障碍的相关因素研究

背景糖尿病中枢神经系统损伤的确切机制仍不十分清楚,故明确糖尿病认知功能障碍的相关因素,乃至危险因素,并进行有针对性的干预,对于延缓、预防糖尿病认知功能障碍的发生、发展有十分重要的意义.设计以诊断为依据的前瞻性病例对照研究.目的对临床可能影响糖尿病患者认知功能的若干因素进行综合分析、判断和研究,以期为进一步大规模的糖尿病人群研究及糖尿病认知功能障碍的危险因素的确定奠定基础和方向.地点和对象共入选糖尿病患者40例,均为随机抽取的2002-02/2002-07,北京宣武医院内分泌科的住院患者.随机选取同期北京市区健康居民80例为对照者.干预以痴呆扩充量表为认知功能的评价工具,对比分析糖尿病患者与对照组的认知功能评分.同时,就糖尿病患者的认知功能评分与相关的临床指标进行相关回归分析,以明确糖尿病认知功能障碍的相关因素.主要观察指标认知功能评分,认知功能评分与相关临床指标的回归分析结果.结果糖尿病组的认知功能评分平均为209.59±20.77,对照组为224.28±10.56,两者比较差异有显著性意义(P＜0.001).经直线相关回归分析,糖尿病患者的认知功能评分与糖化血红蛋白、年龄以及胰岛素基础C肽水平相关,相关系数分别为-4.965,-0.605和-3.729.结论糖尿病认知功能障碍是一多因素、多环节致病的复杂病理过程.可能与糖化血红蛋白、患者的年龄以及胰岛素基础C肽水平相关.

Related factors ofcognitive impairment in diabetic patients

BACKGROUND: The mechanism of diabetic central nervous system injury is still unclear. It is important to clarify the related factors, and even risk factors of diabetic central nervous system injury, carry out target-specific interventions, and thus delay and prevent the occurrence and development of diabetic central nervous system injury.OBJECTIVE: To explore the related factors of diabetic cognitive impairment, and prepare further research on risk factors of diabetic cognitive impairment.DESIGN: A diagnosis-based prospective case-control study.SETTING and PARTICIPANTS: Forty diabetic patients were enrolled in this research. All of them were randomly selected from the Endocrinology Department of Beijing Xuanwu Hospital during February 2002 to July 2002. Eighty healthy residents in Beijing were randomly selected as normal control group.INTERVENTIONS: We evaluated the cognitive function of each subject enrolled in this research with the expansive scale of dementia(ESD) and contrasted the cognitive function scores of diabetic patients with those of normal control group. Meanwhile, regression analysis was conducted on therelationship between diabetic cognitive function score and some clinical indexes, so as to find the related factors of diabetic cognitive impairment.MAIN OUTCOME MEASURES: Cognitive function scores, cognitive function scores of diabetic patients and the results of the regression analysis on some clinical indexes.RESULTS: The mean cognitive scores were significantly different between the diabetic group(209.59±20.77) and the normal control group (224. 28 ± 10. 56) ( t =4. 208, P ＜ 0. 001) . Linear correlation and regression analysis showed that the diabetic cognitive score has a close relationship with glycated hemoglobin(GHB), the ages of diabetic patients, and the basic level of serum insulin-C peptide(CPB), with the correlation coefficients of - 4. 965, - 0. 605 and - 3. 729, respectively.CONCLUSION: Diabetic cognitive impairment is a complicated pathologic course in which many factors and links are involved. It has a close relationship with GHB, the age of diabetic patients, and the basic level of serum insulin-C peptide.