糖化血红蛋白达标与否对2型糖尿病患者认知功能的影响研究  

Influence of Glycosylated Hemoglobin Reaching Standard or Not on the Cognitive Function of Type 2 Diabetes Patients

作　　者：甄艳凤[1] 刘兴宇[2] 徐刚[3] 房辉[1] 孙雪玲[1] 张谷月[1] 李玉凯[1] 周莉[1] 张翠林[1] 

机构地区：[1]唐山工人医院内分泌二科,河北省唐山市063000 [2]唐山工人医院神经外科,河北省唐山市063000 [3]唐山工人医院烧伤科,河北省唐山市063000

出　　处：《中国全科医学》2016年第2期146-149,共4页Chinese General Practice

基　　金：河北省自然科学基金资助项目(H2015105083)

摘　　要：目的探讨糖化血红蛋白(HbA_(1c))是否达标对2型糖尿病(T2DM)患者认知损伤的影响。方法选择2013年4月—2014年9月唐山工人医院内分泌科住院的T2DM患者255例,男119例、女136例。分为HbA_(1c)<7.0%组(A组)、HbA_(1c)7.0%~9.0%组(B组)和HbA_(1c)>9.0%组(C组),采用可重复的成套神经心理状态测验(RBANS)量表评估患者的认知功能,比较组间RBANS评分,分析T2DM患者认知评分的影响因素。结果 T2DM患者RBANS总分与年龄(r=-0.20)、受教育程度(r=0.35)、病程(r=-0.13)及HbA_(1c)(r=-0.19)相关(P<0.05);多元回归分析显示,受教育程度(t=6.16)、HbA_(1c)(t=-4.61)是T2DM患者RBANS总分的影响因素(P<0.05)。校正性别、年龄、受教育程度等因素后,3组患者的即刻记忆(F=14.1)、延迟记忆(F=17.2)和RBANS总分(F=15.9)比较,差异均有统计学意义(P<0.05),B、C组RBANS总分均低于A组,差异有统计学意义(P<0.05)。结论 HbA_(1c)未达标的T2DM患者认知功能损伤较严重,控制HbA_(1c)在达标范围内对预防T2DM患者认知损伤有潜在价值。Objective To investigate the influence of HbAIc on the cognitive injury of T2DM patients. Methods We enrolled 255 T2DM patients who were admitted into the endocrinology department of Tangshan Gongren Hospital from April 2013 to September 2014, including 119 males and 136 females. The subjects were divided into three group： HbAIc 〈 7.0% group （A group）, HbAIc 7.0% -9.0% group （B group） and HbAIc 〉9.0% group （C group）. RBANS was employed to evaluate the cognitive function of the patients. Comparison was made among the three groups in RBANS score, and the influencing factors for the cognitive score of T2DM patients were analyzed. Results The RBANS total score of the patients were related （ P 〈 0.05） with age （r= -0.20）, degree of education （r=0.35）, course of disease （r= -0.13） and HbAIc（r= -0.19）; Multivariate regression analysis showed that degree of education （t = 6. 16） and HbAlo （t = -4. 61 ） were influencing factors for the RBANS total score of T2DM patients （P 〈0. 05）. After the adjustment of gender, age and degree of education, the three groups were not significantly different （ P 〈 0. 05 ） in immediate memory （ F = 14. 1 ） , delayed memory （ F = 17.2） and RBANS total score （ F = 15.9）, and group B and group C were lower than group A in RBANS total scores （ P 〈 0. 05 ）. Conclusion T2DM patients who don＇t reach standard in HbAIc have more serious damage in cognitive function, and the control of HbA^o within standard range may have potential value in the prevention of cognitive injury of T2DM.

关 键 词：糖尿病 2型 血红蛋白A 糖基化 认知障碍 危险因素 

分 类 号：R587.1[医药卫生—内分泌]