合并糖尿病且伴发睡眠障碍的首发老年抑郁症患者认知功能损害及影响因素研究  

Study on the cognitive impairment in first-opisode depression elderly patient with diabetes mellitus and sleep disorders and its influencing factors

作　　者：刘书伟[1] 杨树前 LIU Shuwei;YANG Shuqian(Sleep Medicine Center,the Third People’s Hospital of Huaian,Jiangsu Province,Huaian 223400,China;Department of Geriatric Psychiatry,the Third People’s Hospital of Huaian,Jiangsu Province,Huaian 223400,China)

机构地区：[1]江苏省淮安市第三人民医院睡眠医学中心,江苏淮安223400 [2]江苏省淮安市第三人民医院老年精神科,江苏淮安223400

出　　处：《中国医药导报》2022年第8期113-116,共4页China Medical Herald

基　　金：江苏省自然科学基金项目(BK20190808)。

摘　　要：目的探讨合并糖尿病且伴发睡眠障碍的首发老年抑郁症患者认知功能损害及影响因素。方法选取2019年5月至2021年4月江苏省淮安市第三人民医院收治的166例合并糖尿病且伴发睡眠障碍的首发老年抑郁症患者和90名健康志愿者,分别记为研究组和健康组。比较两组重复性成套神经心理状态监测各项指标评分。统计166例患者认知功能障碍检出率,并依据是否发生认知功能障碍,分为认知功能障碍组和非认知功能障碍组。比较认知功能障碍组和非认知功能障碍组临床资料。logistic回归分析影响合并糖尿病的首发老年抑郁症患者认知功能的危险因素。结果研究组糖尿病病程、17项汉密尔顿抑郁量表(HAMD-17)评分均高于健康组(P<0.05)。研究组即刻记忆、言语功能、注意力、视觉广度、延时记忆及总分均低于健康组(P<0.05)。166例患者认知功能障碍检出率为28.92%。认知功能障碍组合并睡眠障碍占比、颈动脉狭窄占比、糖尿病病程及HAMD-17评分均高于非认知功能障碍组(P<0.05)。logistic回归分析结果显示,合并睡眠障碍、颈动脉狭窄、糖尿病病程及HAMD-17评分均为影响糖尿病首发老年抑郁症患者认知功能的危险因素(OR=3.955、3.483、2.832、2.793,P<0.05)。结论合并糖尿病且伴发睡眠障碍的首发老年抑郁症患者认知功能障碍检出率较高,合并睡眠障碍、颈动脉狭窄、糖尿病病程长及HAMD-17评分高均为影响糖尿病首发老年抑郁症患者认知功能的危险因素,临床中需逐一控制以上各项因素对糖尿病首发老年抑郁症患者的影响,以降低认知功能障碍的发生率。Objective To explore the cognitive impairment of first-episode depression elderly patients with diabetic mellitus and sleep disorders and its influencing factors.Methods From May 2019 to April 2021,166 first-episode elderly patient with diabetes mellitus and sleep disorders and 90 healthy volunteers were enrolled in the Third People’s Hospital of Huaian,Jiangsu Province,and they were divided into study group and health group,respectively.The repeatable battery for the assessment of neuropsychological status scores were compared between the two groups.The detection rate of cognitive dysfunction in 166 patients was analyzed and divided into cognitive dysfunction group and non-cognitive dysfunction group according to whether cognitive dysfunction occurred.The clinical data of the cognitive dysfunction group and the non-cognitive dysfunction group were compared.Logistic regression analysis of risk factors affecting cognitive function in first-episode elderly depression patients with diabetes mellitus and sleep disorders.Results The duration of diabetes mellitus and(Hamilton depression scle-17,HAMD-17)score of the study group were higher than those of the healthy group(P<0.05).The study group had lower immediate memory,speech function,attention,visual span,delayed memory and total score than the healthy group(P<0.05).The detection rate of cognitive dysfunction in 166 patients was 28.92%.The proportion of sleep disorders,carotid artery stenosis,diabetes course and HAMD-17 score in the cognitive dysfunction group were higher than those in the non-cognitive dysfunction group(P<0.05).Logistic regression analysis showed that sleep disorders,carotid artery stenosis,long diabetes course and high HAMD-17 score were all risk factors affecting cognitive function in elderly patients with first-episode diabetic depression(OR=3.955,3.483,2.832,2.793,P<0.05).Conclusion The detection rate of cognitive dysfunction in first-episode elderly depression patient with diabetic mellitus and sleep disorders is higher.Sleep disorders,caroti

关 键 词：老年 睡眠障碍 糖尿病 抑郁症 认知功能 

分 类 号：R587.1[医药卫生—内分泌]