构建痛性糖尿病神经病变患者继发轻度认知功能障碍的预测模型及应用性分析  

Construction and application of predictive model of secondary mild cognitive impairment in patients with painful diabetic neuropathy

作　　者：张淳[1] 湛疆 祁学章[1] 邵婧 赵梦 汪玉宝[1] Zhang Chun Zhan Jiang Qi Xuezhang Shao Jing Zhao Meng Wang Yubao(Department of Geriatrics, Ezhou Central Hospital, Hubei Ezhou 436000, Chin)

机构地区：[1]湖北省鄂州市中心医院老年病科,436000

出　　处：《中国医师进修杂志》2017年第9期795-799,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 构建痛性糖尿病神经病变（PDN）患者继发轻度认知功能障碍（MCI）的预测模型,并验证应用性.方法 连续性纳入2013年3月至2016年3月收治的PDN患者,记录相关临床资料,均随访1年.依据随访结果预判继发MCI风险的影响因素,并验证不良预后事件出现的时间窗.结果 共82例PDN患者完成研究,其中16例患者继发MCI,66例患者于随访期内认知功能正常.Cox回归模型多变量分析结果显示,PDN患者继发MCI的独立影响因素为PDN病程、简明疼痛量表（BPI）评分、神经元特异性烯醇化酶（NSE）（HR=1.238、1.336、1.450,P〈0.05）.PDN病程≥3.367年、BPI评分≥4.704分、NSE≥7.420μg/L的PDN患者,继发MCI的时间窗更短,其中BPI评分和NSE具有更高的评判效能.结论 PDN病程、BPI评分、NSE是PDN患者继发MCI的独立影响因素,且BPI评分≥4.704分、NSE≥7.420μg/L为衡量PDN患者随访期内继发MCI的最佳临界值.Objective To build predictive model of secondary mild cognitive impairment （MCI） in patients with painful diabetic neuropathy （PDN）, and analyze its apply. Methods The patients with PDN were consecutively selected from March 2013 to March 2016. The relevant clinical data were recorded, and the patients were followed up for 1 year. According to the results of follow-up, secondary MCI risk indicators were predicted, and the time window of adverse outcomes event was validated. Results A total of 82 PDN patients completed the study, and secondary MCI occurred in 16 cases. Sixty-six cases had not secondary MCI. The Cox regression model multivariate analysis results showed that the independent influencing factors of secondary MCI was course of PDN, brief pain inventory （BPI） score and neuron-specific enolase （NSE） in patients with PDN （HR = 1.238, 1.336 and 1.450; P〈0.05）. The secondary time window of the MCI in PDN patients with the course of PDN ≥3.367 years, BPI score≥4.704 scores and NSE ≥ 7.420 μg/L was shorter, in whom BPI score and NSE had a higher evaluation ability. Conclusions The courses of PDN, BPI score and NSE are independent influencing factors of secondary MCI in PDN patients, and the BPI score≥4.704 scores and NSE≥7.420μg/L have a higher evaluation ability.

关 键 词：糖尿病 2型 糖尿病神经病变 认识障碍 预测 

分 类 号：R587.2[医药卫生—内分泌]