老年糖尿病合并脑梗死脑功能研究

A Clinical Study on Cerebral Dysfunction in the Elderly Diabetic Patients with Cerebral Infarction

目的:探讨老年2型糖尿病合并脑梗死患者脑功能及其智力、记忆力的特点。方法:采用成人成套神经心理测验〔HRB(A)-RC〕及龚氏修订的韦氏成人智力测验(WAIS-RC)及韦氏记忆测验(WMS-RC)对45例老年2型糖尿病合并脑梗死患者及相匹配的60例非糖尿病性脑梗死患者以及45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、部位对脑功能损害的影响进行分析。结果:老年2型糖尿病合并脑梗死组大部分测验成绩明显低于非糖尿病性脑梗死组和对照组;大片脑梗死比小片脑梗死、皮质下脑梗死特别是基底节、脑室旁、丘脑处脑梗死比皮质脑梗死更易产生脑功能障碍(P<0.05);而多灶脑梗死与单灶脑梗死功能障碍无显著性差异(P>0.05)。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。

Objective:To explore the character of the cerebral function, intelligence and memory in the elderly type 2 diabetes mellitus patients with cerebral infarction. Methods:With testing of Halstead Reitan Battery Revised in China〔HRB(A)-RC〕, Wechsler Adult Intelligence Scale Revised in China(WAIS-RC)and Wechsler Memory Scale Revised in China(WMS-RC), we measured the cerebral function in 45 elderly type 2 diabetes mellitus patients with cerebral infarction and 60 cerebral infarction patients without diabetes mellitus and 45 normal subjects without cerebral infarction served as control. We also analysed the effect of the infarction size, numbers and region on cerebral function damage. Results:The scores of the elderly type 2 diabetes mellitus patients with cerebral infarction in most part were significantly lower than that of the cerebral infarction patient without diabetes mellitus and the controls; The patients who have large cerebral infarction size and are subcortex infarction were liable to induce cerebral dysfunction than the small and the cortex infarction(P<0.05),especially in basal nuclei, paraventricular and thalamus. There is no significant difference between the more and the one cerebral infarction size(P>0.05). Conclusion:The elderly type 2 diabetes mellitus patients with cerebral infarction could induce more obvious cerebral dysfunction.