老年2型糖尿病合并脑梗死患者的脑功能障碍及其智力、记忆力特点

Characteristics of cerebral function intelligence and memory in the elderly type 2 diabetics with cerebral infarction

目的:探讨老年2型糖尿病合并脑梗死患者的脑功能及其智力、记忆力特点。方法:采用成人成套神经心理测验犤HRB(A)-RC〗及龚耀先修订的韦氏成人智力测验(WAIS-RC)及韦氏记忆测验(WMS-RC)对42例老年2型糖尿病合并脑梗死患者(DI组)及相匹配的60例非糖尿病性脑梗死患者(I组)以及43例无脑梗死正常人(对照组)进行测定及比较分析,同时就脑梗死灶的大小、数目、部位对脑功能的影响进行分析。结果:HRB(A)-RC结果:DI组连线测验2.22±0.43,触摸时间33.62±3.61,脑功能成绩和总智商FIQ(75.64±8.59)及记忆商M(65.40±10.27均明显低于I组(1.75±0.14,29.72±3.23,96.67±9.61,86.20±7.59)和对照组(1.55±0.11,20.38±3.19,104.49±5.68,97.33±6.29),差异有显著性意义(P<0.01);大片脑梗死(FIQ≤79占46.9%,MQ≤79,62.5%)比小片脑梗死(22.9%比35.7%)、皮质下脑梗死(40.1%比57.9%)特别是基底核、脑室旁、丘脑处脑梗死比皮质脑梗死(16.3%比25.6%)更易产生脑功能障碍(χ2=5.9882～10.3864,P<0.05～0.01),多灶脑梗死与单灶脑梗死功能障差异无显著性意义(P>0.05);DI组中大片脑梗死及皮质下脑梗死较I组多(χ2=11.5069～18.2021,P<0.01)。结论:老年2型糖尿病合并脑梗死可引起明显的脑功能障碍。

AIM:To explore the cerebral function of the elderly with type 2 diabetics comp anied with cerebral infarction and the characteristics of their intelligence and memory. METHODS:By using Halstead Reitan Battery Revised in China, Wechsle r adult intelligence scale revised in China(WAIS-RC) and Wechsler memory scale revised in China(WMS-RC),the cerebral function was measured and compared in 42 elderly type 2 diabetics with cerebral infarction(DI group) and 60 elderly cereb ral infarction patients without diabetes mellitus(I group) and 43 normal subject s without cerebral infarction(N group).The effects of infarct size, number and s ite on cerebral function were also analyzed. RESULTS:The scores of cerebral function such as trail making test (2.22±0.43) and tactual time test(33.62±3.61) and full intelligent quotients(FIQ)(75.64±8 .59) and memory quotients(MQ)(65.40±10.27) in the DI group were significantly l ower than those in the D group(1.75±0.14)(29.72±3.23)(96.67±9.61)(86.20±7.59 )(P< 0.01) and the N group(1.55±0.11 ),(20.38±3.19 ),(104.49±5.68),(97.33±6. 29)(P< 0.01).The patients with large cerebral infarct size(46.9%with FIQ≤79,62 .5%with MQ≤79)and those with subcortical infarction(40.1%,57.9%) were liable to induce cerebral dysfunction than those with small (22.9%,35.7%) or cortica l infarction(16.3%, 25.6%)(χ2=5.988 2-10.386 4,P< 0.05-0.01),especially in basal nuclei,paraventricular and thalamus.There was no significant difference be tween the patients with multiple and single cerebral infarction(P >0.05).The pat ients with large cerebral infarct size and those with subcortical infarction in the DI group were obviously more than those in the I group(χ2=11.506 9-18.202 1,P< 0.01). CONCLUSION:The elderly type 2 diabetes with cerebral infarction can induce mor e obvious cerebral dysfunction.