不同程度酮症酸中毒对T1DM儿童执行功能的影响  

Effect of ketoacidosis at varying degrees on executive function in children with type 1 diabetes mellitus

作　　者：李宝琪[1] 乔木[1] 杨璐 赵欣欣 郭园丽 LI Baoqi;QIAO Mu;YANG Lu(Department of Pediatrics,First Hospital of Qinhuangdao,Hebei,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院儿科,066000

出　　处：《河北医药》2024年第10期1528-1531,共4页Hebei Medical Journal

基　　金：秦皇岛市科学技术研究与发展计划(编号:202301A278)。

摘　　要：目的基于威斯康星卡片分类测验(WCST)探讨不同程度酮症酸中毒(DKA)对1型糖尿病(T1DM)儿童执行功能的影响。方法纳入2017年3月至2022年9月于秦皇岛市第一医院住院治疗的DKA患儿118例,根据DKA严重程度分为轻度组(n=37)、中度组(n=40)和重度组(n=41),另选取同期医院收治的新诊无DKA的T1DM患儿36例作为对照。收集一般资料,采用WCST评估患儿执行能力,采用中国修订韦氏儿童智力量表(C-WISC)评估患儿认知功能。结果与非DKA组比较,DKA患儿随机血糖显著升高,酸碱度(pH值)和碳酸氢根(HCO_(3)^(-))显著降低,完成分类数、概念化水平显著降低,错误应答数、持续性错误数、持续性应答数显著增加,分类、知识、算术、领悟、词汇、填图、图片排列、积木、图形拼接、编码、言语智商、操作智商及总智商显著降低,并与DKA病情程度有关(P<0.05);执行功能与患儿认知功能呈正相关(r=0.698,P<0.05)。结论DKA可引起T1DM儿童执行功能障碍,随着病情程度加重损伤越明显,且执行功能与认知功能具有显著关联。Objective To explore the effect of ketoacidosis(DKA)at varying degrees on executive function in children with type 1 diabetes mellitus(T1DM)based on the Wisconsin card sorting test(WCST).Methods A total of 118 children with DKA hospitalized in First Hospital of Qinhuangdao from March 2017 to September 2022 were included.According to the severity of DKA,they were divided into mild group(n=37),moderate group(n=40)and severe group(n=41).Another 36 newly diagnosed T1DM children without DKA were selected as control group.General data were collected.WCST was used to evaluate executive ability,and Chinese version of the Wechsler Intelligence Scale for Children(C-WISC)was used to evaluate cognitive function.Results Compared with those of the control group,children in DKA group presented significantly higher random blood glucose and lower pH and HCO3 levels(P<0.05).The numbers of completed classification and conceptual level were significantly lower,and the numbers of wrong answers,persistent errors and persistent answers were significantly higher in children of DKA group(P<0.05).The classification,knowledge,arithmetic,comprehension,vocabulary,mapping,picture arrangement,building blocks,graphic mosaic,coding and verbal IQ were significantly higher,and operation intelligence quotient and total intelligence quotient were significantly lower,which were correlated with the degree of DKA(P<0.05).Executive function was positively correlated with cognitive function(r=0.698,P<0.05).Conclusion DKA can cause executive dysfunction in children with T1DM,and the damage is more obvious with the aggravation of the disease.There is a significant correlation between executive function and cognitive function in T1DM children.

关 键 词：1型糖尿病 糖尿病酮症酸中毒 威斯康星卡片分类测验 执行功能 认知功能 儿童 

分 类 号：R587.1[医药卫生—内分泌]