老年2型糖尿病合并高血压患者认知功能改变特点及危险因素研究  

Research on Characteristics and Risk Factors of Cognitive Function in Elderly Patients with Type 2 Diabetes Mellitus Complicated with Hypertension

作　　者：刘闻莺[1] 沈莉[1] 张嫣[1] 徐辰飞 

机构地区：[1]上海市普陀区真如镇社区卫生服务中心,上海200333

出　　处：《中国初级卫生保健》2017年第11期48-51,共4页Chinese Primary Health Care

摘　　要：目的分析老年2型糖尿病合并高血压患者认知功能的改变特点和相关危险因素。方法选取2016年9月—2017年6月在上海市普陀区真如镇社区卫生服务中心门诊和住院诊治的225例老年患者为研究对象,其中单纯糖尿病患者78例为A组,单纯高血压患者84例为B组,糖尿病合并高血压患者63例为C组,收集患者的一般资料,测定生化指标。采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)、简易智能状态量表(Mini-Mental State Examination,MMSE)对三组患者进行认知功能评价,了解患者认知功能的改变特点。根据Mo CA评分,将225例患者筛选出轻度认知障碍(MCI)组86例和非MCI组139例,分析两组患者认知功能的改变特点和相关危险因素。结果 C组Mo CA评分明显低于A组、B组,C组命名、注意力明显低于B组,三组之间抽象思维差异有统计学意义;C组患者MCI发生率明显高于A组和B组(P<0.05)。MCI组与非MCI组患者在年龄、受教育年限、FPG、Hb A1c和HCY的差异有统计学意义(P<0.05)。多元回归分析结果显示:年龄、HCY和Hb A1c是老年患者发生认知功能损害的危险因素,受教育年限是发生认知功能损害的保护因素(P<0.05)。结论老年2型糖尿病合并高血压患者MCI发生率明显高于单纯糖尿病组和单纯高血压组。OBJECTIVE To investigate the characteristics of cognitive function in elderly patients with type 2 diabetes mellitus and hy-pertension,and to analyze related risk factors.METHODS A total of 225 elderly inpatients and outpatiouts admitted in Zhenru Town-ship Community Health Service Center from September 2016 to June 2017.They were divided into simple diabetes mellitus as Agroup(n=78),simple hypertension as B group(n=84),diabetic patients with hypertension as C group(n=63).General data of patientswere collected and biochemical indexes were measured.The Montreal cognitive assessment scale(Mo CA),Mini-Mental State Examina-tion(MMSE) for the evaluation of cognitive function of three groups of patients.The investigation was focus on the change of cognitivefunction in the three groups.According to the Mo CA score,225 patients were divided into MCI group(n=86) and non MCI groups(n=139).The characteristics of cognitive function change and related risk factors were analyzed in the two groups.RESULTS Comparingthree groups of patients with cognitive function score,Mo CA score in C group was significantly lower than that of A group,B group.Naming,attention in group C was significantly lower in group B.There was statistical significance of abstract thinking in the threegroups.The incidence rate of MCI in C group was significantly higher than that of A group and B group(P<0.05).The difference be-tween the MCI group and the non MCI group in age,length of education,FPG,Hb A1 c,HCY was statistically significant(P<0.05).Multiple regression analysis showed that age,HCY and Hb A1 c were risk factors of cognitive impairment in elderly patients,and theduration of education was the protective factor of cognitive impairment.CONCLUSION The incidence of MCI in elderly patients withtype 2 diabetes mellitus and hypertension was higher than that of simple diabetes group and simple hypertension group.

关 键 词：老年人 糖尿病 2型 高血压 轻度 认知功能障碍 

分 类 号：R587.1[医药卫生—内分泌]