老年2型糖尿病患者认知功能与血压昼夜节律变化特点  

Relationship between 24-hour ambulatory blood pressure circadian rhythm and cognition function in the patients of elderly type 2 diabetes

作　　者：徐军霞[1] 王建军[1] 詹开宇[1] 吴海棠[2] 张冬梅[1] 

机构地区：[1]南京军区福州总医院干部病房二科,350025 [2]南京军区福州总医院心电图室,350025

出　　处：《中华保健医学杂志》2011年第3期217-220,共4页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨老年2型糖尿病(T2DM)患者认知功能与24h动态血压昼夜节律变化特点。方法选择270例老年T2DM患者为糖尿病组,另选择同期健康体检者100例为对照组。对两组行24h动态血压监测,根据夜间血压下降率(ΔMBP)分为杓型(△MBP10%～20%,n=95)、非杓型(△MBP0%～<10%,n=86)、超杓型(△MBP>20%,n=47)和反杓型(△MBP<0%,n=42);用中文版简易智能状态检查表(MMSE)对所有受试者进行认知功能调查,比较各组间MMSE得分的差异。结果糖尿病组患者MMSE得分[(24.34±2.51)分]低于对照组[(28.88±3.02)分],差异有统计学意义(P<0.05)。糖尿病组中非杓型[(24.77±2.53)分]、超杓型[(23.34±2.41)分]和反杓型[(23.03±2.26)分]患者的MMSE得分均低于杓型[(26.03±2.68)分]患者,超杓型和反杓型又低于非杓型患者,差异有统计学意义(P<0.05),但超杓型和反杓型之间的差异无统计学意义。Pearson相关分析显示,糖尿病患者MMSE得分与24hSBP(r=-0.73)、24hDBP(r=-0.60)、24hPP(r=-0.54)、24hMBP(r=-0.56)呈负相关(P<0.05)。结论 24h动态血压昼夜节律的减弱或消失可能是老年T2DM患者认知功能受损的相关因素。Objective To study the relationship between 24-hour ambulatory blood pressure circadian rhythm and cognition function in the patients of elderly type 2 diabetes. Methods Two hundred and seventy elderly patients of type 2 diabetes were performed 24-hour ambulatory blood pressure monitoring（ABPM）,and divided into dipper group（n=95）,non-dipper group（n=86）,super-dipper group（n=47） and reverse-dipper group（n=42）. 100 healthy subjects served as control. Cognition function were evaluated by Mini-Mental State Examination（MMSE）. Results MMSE of type 2 diabetes group was significantly lower than that of control（24.34±2.51 vs. control：28.88±3.02,P〈0.05）. MMSE of non-dipper group,super-dipper group and reverse-dipper group were significantly lower than that of dipper group,super-dipper group and reverse-dipper group were also lower than that of non-dipper group（non-dipper：24.77±2.53 vs. super-dipper：23.34±2.41 vs. reverse- dipper：23.03±2.26 vs. dipper：26.03±2.68,respectively P〈0.05）,but there was no significant difference between super-dipper and reverse-dipper group. Pearson correlation analysis showed that,MMSE was negatively correlated with 24hSBP（r=-0.73）,24hDBP（r=-0.60）,24hPP（r=-0.54）and 24hMBP（r=-0.56）（all P〈0.05）. Conclusions The decrease on cognition function in the patients of elderly type 2 diabetes may be related with the attenuation or disappearance of 24-hour ambulatory blood pressure circadian rhythm.

关 键 词：2型糖尿病 认知功能 24H动态血压 昼夜节律 老年 

分 类 号：R587.1[医药卫生—内分泌]