遵义地区68例中老年2型糖尿病患者认知功能下降相关因素分析  

Analysis of factors associated with cognitive decline in 68 middle-aged and elderly patients with type 2 diabetes patients of Zunyi region

作　　者：罗秀梅 李园园 周香 施尚鹏 蔡攀 罗勇 Luo Xiumei;Li Yuanyuan;Zhou Xiang;Shi Shangpeng;Cai Pan;Luo Yong(Department of Neurology,The Third Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China;Drug Clinical Trial Institution,The Third Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China;Department of Cardiology,The Third Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China;Quality Control Institution,The Third Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China;Department of Neurology,The First Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China)

机构地区：[1]遵义医科大学第三附属医院神经内科,贵州遵义563000 [2]遵义医科大学第三附属医院药物临床试验机构办公室,贵州遵义563000 [3]遵义医科大学第三附属医院心内科,贵州遵义563000 [4]遵义医科大学第三附属医院质管部,贵州遵义563000 [5]遵义医科大学第一附属医院神经内科,贵州遵义563099

出　　处：《遵义医科大学学报》2020年第4期523-527,共5页Journal of Zunyi Medical University

基　　金：遵义市汇川区科技计划项目(NO:遵汇科合201517);遵义市科技计划项目(NO:2016-08)。

摘　　要：目的探讨遵义地区68例中老年人中,2型糖尿病(T2DM)患者认知功能下降的相关因素。方法选择2018年2月至2019年2月在遵义医科大学第三附属医院住院的中老年(45~80岁)T2DM患者68例,采用简易智力状态检查量表(MMSE)评估其认知功能,并将患者分为认知功能下降组(46例)和认知功能正常组(22例),收集研究对象的一般人口学资料及相关生化指标(餐后2 h胰岛素、餐后2 h糖(2 hPG)、餐后2 h肽,空腹C肽、TG、TSH、HbA lc、FPG、Fins、CHOL、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、β淀粉样蛋白(Aβ1-42)、胰岛素降解酶(IDE)、稳态模型(HOMA)的胰岛素抵抗指数(HOMA-IR))进行统计学分析。结果本地区T2DM患者认知功能下降组较认知功能正常组相比,合并患高血压患病率高(81.82%vs 54.29%,P=0.015)、T2DM病程5年以上比例较高(78.95%vs 53.33%,P=0.025),T2DM患者认知功能下降组的餐后2 h血糖(2hPG)值更高[(46.79±31.17)vs(31.72±16.39),P=0.041],年龄、β-淀粉样蛋白1-42(Aβ1-42)水平与MMSE评分呈负相关性。结论本地区T2DM患者病程越长、年龄越大和2hPG水平、血清Aβ1-42水平越高,认知功能障碍发生率越高。Objective To explore the related factors of cognitive decline in type 2 diabetes(T2DM)among middle-aged and elderly people in northern Guizhou.Methods A total of 68 middle-aged and elderly patients(aged 45~80 years old,including 45 and 80 years old)with T2DM hospitalized in the Third Affiliated Hospital of Zunyi Medical University from February 2018 to February 2019 were selected to have their cognitive function assessed using the simple mental status check scale(MMSE),and the patients were divided into a cognitive decline group(46 cases)and a normal cognitive function group(22 cases).The general demographic data and relevant biochemical indicators of the study subjects,such as fasting C peptide,blood insulin 2 h after meal,blood glucose 2 h after meal(2hPG),C peptide 2 h after meal,TG,TSH,HbA lc,FPG,Fins,CHOL,low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),β-amyloid(Aβ1-42),insulin degrading enzyme(IDE),homeostasis model(HOMA),and insulin resistance index(HOMA-IR)were collected for statistical analysis.Results Compared with the group with normal cognitive function,T2DM patients with cognitive decline in this region had a higher prevalence of hypertension(81.82%vs 54.29%,P=0.015),and a higher proportion of patients with T2DM over 5 years(78.95%vs 53.33%,P=0.025).The 2hPG value of T2DM patients with cognitive decline was higher[(46.79±31.17)vs(31.72±16.39),p=0.041].Age and the level of Aβ1-42 was negatively correlated with the MMSE score.Conclusion The longer the course of the disease,the older the age,and the higher 2HPG level and serum Aβ1-42 level in this region,the higher the incidence of cognitive dysfunction.

关 键 词：中老年 2型糖尿病 认知功能 

分 类 号：R741[医药卫生—神经病学与精神病学]