2型糖尿病患者轻度认知功能障碍的特点及其危险因素

The placebo-controlled study of type 2 diabetes patients with mild cognitive impairment

目的观察2型糖尿病患者轻度认知功能障碍特点及相关危险因素。方法从无锡地区痴呆的流行病学调查对象中筛选出82例高血压患者,84例糖尿病患者,76例糖尿病合并高血压患者以及年龄、性别及文化程度相匹配的80名正常对照者,以上四组均进行认知功能筛查问卷调查,同时检测胆固醇、甘油三酯、血压。高血压和糖尿病患者进行空腹胰岛素测定,计算胰岛素抵抗指数。糖尿病人给予糖化血红蛋白测定,并对四组人群的认知功能和危险因素进行对照分析。结果①糖尿病组在时间定向,个人经历,近事记忆,做事质量,判断力人格变化上与正常老年组有统计学差异(P<0.05)。②糖尿病合并高血压组在近事记忆,语言问题,人格变化等方面与正常老年组有统计学差异(P<0.05)。③糖尿病合并高血压组较糖尿病组在个人经历上有统计学差异(P<0.01)。④糖尿病组较高血压组在语言问题,人格变化上有统计学差异(P<0.05)。⑤高血压组与正常组没有统计学差异(P>0.05)。⑥胰岛素抵抗指数与问卷得分呈负相关。结论①2型糖尿病患者较同龄正常老年人存在轻度认知功能障碍,合并高血压的糖尿病患者的认知功能损害更严重。②糖化血红蛋白与胰岛素抵抗是认知功能障碍的危险因素。③糖尿病患者在记忆力损害的同时还存在精神症状和人格变化。

Objective To observe the character of type 2 diabetes patients with mild cognitive impairment and analyze the associated risk factors.Methods From Alzheimer′s epidemiology objects in Wuxi region,82 patients with hypertension,84 patients with type 2 diabetes,76 cases of diabetes mellitus and hypertension patients as well as age,gender and educational level matching 80 normal control were selected,The cognitive function screening questionnaire was used.The levels of cholesterol,triglycerides,blood pressure were tested.The levels of fasting insulin,insulin resistance index were measured in patients with hypertension and diabetes.The level of glycosylated hemoglobin was tested for diabetics.The risk factors of cognitive function of four groups were analyzed.Results（1） The spatial orientation,personal experience,episodic memory,work quality,personality changes were statistically different between diabetes group and normal group.（2） The episodic memory,memory of past events,language problems,Abstract thinking were statistically different between diabetes group and hypertension group.（3）The personal experience was statistically different between diabetes group and diabetes and hypertension group.（4） The language issues and personality changes were statistically different between diabetes group and hypertension group.（5） hypertension group and normal group had no statistical differences.（6） IRI and the score of questionnaire had negative correlation.Conclusions（1） Patients with type 2 diabetes have mild cognitive impairment,and patients with hypertension and diabetic have more serious cognitive impairment.（2） Glycated hemoglobin and insulin resistance are risk factors of cognitive impairment.（3） The patients with diabetes have memory impairment,psychiatric symptoms and personality changes.