老年2型糖尿病肾病患者肾小球滤过率对认知功能的影响  

Effect of glomerular filtration rate on cognitive function in elderly patients with type 2 diabetic nephropathy

作　　者：马宇敏 成殷勤 金慧 李洪彬[1] 陈伟观[2] MA Yumin;CHENG Yinqin;JIN hui;LI hongbin;CHEN Weiguan(Department of Endocrinology,the Second People's Hospital of Nantong City,Jiangsu Province,Nantong226000,China;Department of Rehabilitation Medicine,Affiliated Hospital of Nantong University,Jiangsu Province,Nantong226001,China)

机构地区：[1]江苏省南通市第二人民医院内分泌科,江苏南通226000 [2]南通大学附属医院康复医学科,江苏南通226001

出　　处：《中国当代医药》2023年第20期97-100,105,共5页China Modern Medicine

基　　金：江苏省老年医学临床技术应用研究项目(LR2021025);江苏省南通市卫生健康委员会科研课题(QA2021036);江苏省南通市基础科学研究和社会民生科技计划项目(JC12022009)。

摘　　要：目的通过横断面研究分析老年2型糖尿病肾病(T_(2)DN)患者认知功能障碍与估算的肾小球滤过率(eGFR)的关系。方法选取2018年1月至2021年12月南通市第二人民医院内分泌科收治的186例老年2型糖尿病(T_(2)DM)患者作为研究对象,按照eGFR数值分为对照组[eGFR≥60 ml/(min·1.73 m^(2))]81例及T_(2)DN组[eGFR<60 ml/(min·1.73 m^(2))]105例,收集患者的一般资料(包括年龄、性别、糖尿病病程、血压、受教育年限、肌酐、糖化血红蛋白、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等),结合蒙特利尔认知评估(MoCA)量表及可重复的成套心理状态测量表(RBANS),比较两组患者认知功能是否存在差异。结果T_(2)DN组患者的糖尿病病程长于对照组,收缩压、舒张压、糖化血红蛋白、肌酐、eGFR均高于对照组,轻度认知功能障碍(MCI)发生率高于对照组,差异有统计学意义(P<0.05);两组患者的年龄、性别、受教育年限、MoCA评分、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇比较,差异无统计学意义(P>0.05)。T_(2)DN患者的eGFR水平与其即刻记忆分值、视觉广度分值、注意力分值、延迟记忆分值及RBANS总分均呈正相关(P<0.05),但与言语功能分值无显著相关性(P>0.05)。采用偏相关系数控制协变量后,T_(2)DN患者eGFR水平是RBANS总分及即刻记忆分值、视觉广度分值、注意力分值、延迟记忆分值的影响因素。结论T_(2)DN患者发生认知障碍的风险较高,其eGFR水平可能影响认知功能。Objective To analyze the relationship between cognitive dysfunction and glomerular filtration rate(eGFR)in elderly patients with type 2 diabetic nephropathy(T_(2)DN)through a cross-sectional study.Methods One hundred and eighty-six elderly patients with type 2 diabetes mellitus(T_(2)DM)admitted to the Department of Endocrinology of the Second People's Hospital of Nantong City from January 2018 to December 2021 were selected for the study,and were divided into 81 cases in the control group(eGFR≥60 ml/[min·1.73 m^(2)])and 105 cases in the T_(2)DN group(eGFR<60 ml/[min·1.73 m^(2)])according to eGFR values,and the patients were collected general information(including age,gender,duration of diabetes,blood pressure,years of education,creatinine,glycated haemoglobin,triglycerides,high-density cholesterol and low-density cholesterol)was collected,together with the Montreal cognitive assessment(MoCA)scale and the repeatable battery of mental status(RBANS),to compare whether there were differences in cognitive function between the two groups.Results The course of diabetes in T_(2)DN group was longer than that in control group,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,creatinine and eGFR were higher than those in control group,and the incidence of mild cognitive impairment(MCI)was higher than that in control group,with statistical significances(P<0.05).There were no significant differences in age,sex,years of education,MoCA score,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol between the two groups(P>0.05).eGFR level in T_(2)DN patients was positively correlated with immediate memory score,visual span score,attention score,delayed memory score and RBANS total score(P<0.05),but not significantly correlated with speech function score(P>0.05).After controlling for covariates with partial correlation coefficient,eGFR level in T_(2)DN patients was the influencing factor for RBANS total score and immediate memory score,visual span score,attention score,

关 键 词：2型糖尿病 糖尿病肾病 肾小球滤过率 轻度认知功能障碍 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]