老年代谢综合征患者胰岛素抵抗,脑血流灌注及认知功能研究  

Insulin resistance,cerebral blood flow and cognitive function in elderly patients with metabolic syndrome

作　　者：卢晓喆[1] 施小梅[1] 黄延焱[1] 

机构地区：[1]复旦大学附属华山医院老年病科,上海200040

出　　处：《临床内科杂志》2008年第6期383-385,共3页Journal of Clinical Internal Medicine

摘　　要：目的探究代谢综合征(MetS)及其组分糖尿病或糖耐量异常(DM/IGT)与认知功能的关系。方法选取华山医院老年病科住院患者90例,其中代谢综合征(MS)伴DM/IGT组28例,MS不伴DM/IGT组30例,非MS组32例。入选对象计算胰岛素抵抗指数(HOMA-IR),进行韦氏智力量表测试及单光子发射型计算机体层摄影(SPECT)脑血流显像。结果MS组大部分脑区脑区血流灌注明显低于非MS组,MS伴DM/IGT组在左基底节、右顶叶、右颞叶、扣带回血流灌注低于MS不伴DM/IGT组。MS伴DM/IGT组,不伴DM/IGT组,非MS组FIQ依次降低。MS组HO-MA-IR高于非MS组,但伴或不伴DM/IGT两组之间无统计学差异。结论MS增加老年性认知功能减退的危险。MS患者胰岛素抵抗增加及动脉硬化是两大重要致病原因。Objective To investigate the relationship between Metabolic Syndrome and cognitive impairment in old population.Methods Totally 90 patients hospitalized in Geriatric Department of Huashan Hospital were assigned to 3 groups according to diseases：MetS with DM/IGT,MetS without DM,Normal.All the patients were examined with SPECT and Wais-RC Test.Insulin resistance was estimated by the Insulin Resistance Index of Homeostasis Model Assessment.Results Significant differences were found in perfusions at most lobes in MetS patients with or without DM/IGT and in controls （P〈0.05）.We found perfusion at left basal ganglia,right parietal,right temporal and cingular gyrus were lower in MetS patients with DM/IGT than those without DM.FIQ declined gradually by groups of normal,MetS without DM/IGT and MetS with DM/IGT.HOMA-IR were higher in both MetS groups than in normal,but showed no different between MetS patients with and without DM/IGT.Conclusions MetS may be the risk factor of aging cognitive impairment.Accelerated cerebrovascular atherosclerosis and increased insulin resistance may contribute to cognitive decline in MetS patients.

关 键 词：代谢综合征 单光子发射型计算机体层摄影术 胰岛素抵抗 认知功能 

分 类 号：R589[医药卫生—内分泌] R587.1[医药卫生—内科学]