血糖变异性与急性脑梗死伴糖尿病患者短期认知功能的相关性分析  

Association of blood glucose variability with short-term cognitive function in patients with acute cerebral infarction complicated with diabetes mellitus

作　　者：鲁国[1] 黄新颖[1] 刘宏伟[2] Guo Lu;Xin-ying Huang;Hong-wei Liu(Department of Neurology,Dezhou People's Hospital,Dezhou,Shandong 253000,China;Department of Nuclear Medicine,Dezhou People's Hospital,Dezhou,Shandong 253000,China)

机构地区：[1]山东省德州市人民医院神经内科,山东德州253000 [2]山东省德州市人民医院核医学科,山东德州253000

出　　处：《中国现代医学杂志》2018年第28期61-66,共6页China Journal of Modern Medicine

基　　金：山东省医药卫生科技发展计划项目(No:2017WS537)

摘　　要：目的探讨血糖变异性与急性脑梗死伴糖尿病患者短期认知功能的相关性。方法选取2015年3月-2017年3月德州市人民医院接受治疗的124例急性脑梗死伴糖尿病患者为研究对象。统计一般资料,入院24 h内对其进行72 h动态血糖监测,统计其平均血糖值(GluAve)、血糖标准差(GluSD)、24 h平均血糖波动幅度(MAGE)、血糖不稳定指数(GLI)、血糖变异率(GV)。入院时、入院2周时应用美国国立卫生院卒中量表(NIHSS)、蒙特利尔认知评估量表(MoCA)测评患者短期认知功能。根据MoCA得分将患者划分为认知功能障碍组和认知功能正常组,比较两组各基线指标差异,评估动态血糖监测指标与入院2周时NIHSS、MoCA的相关性,以及动态血糖监测指标对预测认知功能障碍的效能。结果认知功能障碍组空腹血糖、糖化血红蛋白、GluAve、GluSD、MAGE、GLI、GV均高于认知功能正常组(P<0.05)。GluAve、GluSD、MAGE、GLI、GV与入院2周时NIHSS评分呈正相关、与MoCA评分呈负相关,相关性差异有统计学意义(P<0.05)。GluAve、GluSD、MAGE、GLI、GV对预测认知功能障碍均有可靠价值,受试者工作特征曲线下面积为0.675~0.927(P<0.05)。结论 GluAve、GluSD、MAGE、GLI、GV均与急性脑梗死伴糖尿病患者短期认知功能障碍有关,早期检测血糖变异性,降低血糖并减少血糖波动可能有助于改善患者预后。Objective To investigate the correlation between blood glucose variability and short-term cognitive function in the patients with acute cerebral infarction complicated with diabetes mellitus.Methods Totally 124 patients of acute cerebral infarction complicated with diabetes mellitus treated in our hospital from March 2015 to March 2017 were involved.Their general data were observed.The average blood glucose(GluAve),standard deviation of glucose(GluSD),mean amplitude of glycemic excursions in 24 h(MAGE),glycemic index(GLI)and glucose variability(GV)were detected by 72-h dynamic monitoring of blood glucose started within 24 h after admission.The short-term cognitive function of the patients was measured by National Institute of Health Stroke Scale(NIHSS)and Montreal Cognitive Assessment Scale(MoCA)at admission and 2 w after admission.The patients were divided into a cognitive dysfunction group and a normal cognition group according to MoCA score.The differences in baseline indicators were compared between the two groups.The correlations between blood glucose variability and short-term cognitive function were analyzed,and the predicting value of blood glucose variability on cognitive dysfunction was observed.Results The fasting blood glucose,glycosylated hemoglobin,GluAve,GluSD,MAGE,GLI and GV in the cognitive dysfunction group were significantly higher than those in the normal cognition group(P<0.05).GluAve,GluSD,MAGE,GLI and GV were positively correlated with the NIHSS score,and negatively correlated with the MoCA score 2 w after admission(P<0.05).GluAve,GluSD,MAGE,GLI and GV had reliable value in predicting cognitive dysfunction,the area under the ROC curve ranged from 0.675 to 0.927(P<0.05).Conclusions GluAve,GluSD,MAGE,GLI and GV are all correlated with short-term cognitive dysfunction in the patients with acute cerebral infarction complicated with diabetes mellitus.Detection of blood glucose variability in early stage,reduction of blood glucose and blood glucose fluctuation may help to improve the prognosis of

关 键 词：血糖变异性 急性脑梗死 糖尿病 认知功能 

分 类 号：R587.1[医药卫生—内分泌]