2型糖尿病患者轻度认知功能障碍的危险因素分析  

Risk Factors of Mild Cognitive Impairment in Patients with Type 2 Diabetes

作　　者：陈蕊华[1] 蒋晓真[1] 赵晓晖[2] 秦玉兰[1] 顾哲[1] 顾佩莉[1] 周斌[1] 朱震宏[1] 徐凌燕[1] 邹宇峰[1] 

机构地区：[1]上海市浦东新区人民医院内分泌科,201200 [2]上海市浦东新区人民医院神经内科,201200

出　　处：《中国全科医学》2012年第24期2758-2761,共4页Chinese General Practice

基　　金：上海市卫生局科研课题(2009214);上海市浦东新区科技发展基金创新基金(PKJ2010-Y25)

摘　　要：目的探讨2型糖尿病患者轻度认知功能障碍(MCI)的危险因素。方法选用蒙特利尔认知评估(MoCA)北京版量表作为认知功能的测评工具,选择2型糖尿病合并MCI组患者93例(MCI组)和2型糖尿病无MCI患者64例(NC组)。收集两组患者的个人史、家族史,检测体质指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、C肽、血脂、血压及颈动脉彩超。结果 MCI组患者高血压病史、糖尿病病程及C肽水平、最大颈动脉内膜中层厚度(IMT)、最小颈动脉阻力指数(RI)与NC组比较,差异均有统计学意义(P<0.05);而两组患者高脂血症病史及其病程、糖尿病家族史、高血压病程、性别构成、年龄、BMI、WHR、血压、血糖(FPG、HbA1c)及血脂水平间差异无统计学意义(P>0.05)。患者的C肽水平与MoCA量表评分呈正相关(P<0.01),高血压病史、糖尿病病程、最大IMT、最小RI与MoC量表评分呈负相关(P<0.05)。多元回归分析显示,高血压病史、C肽水平及最小RI是MoCA量表评分的独立危险因素(P<0.01)。结论 2型糖尿病病程、高血压病史、C肽、颈动脉IMT及颈动脉RI可能是患者发生MCI的危险因素。Objective To evaluate the risk factors of mild cognitive impairment （MCI） in patients with type 2 diabe- tes. Methods Montreal Cognitive Assessment （MoCA） （Beijing Version） was used as cognition assessment tool. 93 type 2 dia- betic patients with MC1 （MCI group） and 49 type 2 diabetic patients with normal cognitive function （NC group） were enrolled as subjects, hfformation of disease history, family history, BMI, WHR, FPG, HbA^o, C- P, blood lipid, SBP, DBP and ca- rotid color ultrasound were collected. Results There were statistically significant differences in the history of hypertension, course of diabetes mellitus, C -P level, Max C -IMT, Min carotid resistant index （C -RI） between the MCI group and NC group （ P 〈0. 05 ） . No statistieally significant differences were found in ＂the history and course of hyperlitipidaemia, history of dia-betes mellitus, course of HBP, sex composition, BMI, WHR, blood sugar （ FPG, HbAlo ） , SBP, DBP and blood lipid be- tween the MCI group and NC group （ P 〉 0. 05 ） . MoCA scores were positively correlated with C - P level （ P 〈 0. 01 ）, and were negatively correlated with the history of HBP, course of diabetes mellitus, Max C - IMT and Min C - RI （ P 〈 O. 05 ）. Multiple regression analysis showed that history of hypertension, C - P level and Min C - RI were independent risk factors for the MoCA scores （P 〈 O. 01 ） . Conclusion The course of diabetes mellitus, history of HBP, C - P levels, C - IMT and C - RI might be risk factors for MCI in type 2 diabetic patients.

关 键 词：糖尿病 2型 认知障碍 蒙特利尔认知评估量表 危险因素 

分 类 号：R587.1[医药卫生—内分泌]