海马体积对糖尿病认知功能障碍的诊断价值

Predict value of hippocampal volume for diabetes mellitus with diabetic mild cognitive impairment

目的探讨海马体积对糖尿病认知功能障碍诊断价值。方法选择糖尿病合并认知功能障碍(DM+MCI)组20例、病例对照组(DM组)20例、空白对照组(CON组)25例,采用蒙特利尔认知评估(MoCA)量表测评各组认知功能,行磁共振海马成像。结果DM+MCI组年龄、空腹血糖、糖化血红蛋白、甘油三酯、总胆固醇、MOCA评分高于DM组及CON组(P<0.05)。DM+MCI组双侧海马的体积明显变小,与MOCA评分具有相关性。左侧海马体积诊断糖尿病认知功能障碍的ROC曲线下面积为0.793(P<0.05)。在最优截断点时,左侧海马体积为2.845 cm^3时诊断糖尿病认知功能障碍的灵敏度为95%,特异度为65%,阳性预测值为65%,阴性预测值为35%。右侧海马体积诊断糖尿病认知功能障碍的ROC曲线下面积为0.817(P<0.05)。在最优截断点时,左侧海马体积为2.875 cm^3时诊断糖尿病认知功能障碍的灵敏度为90%,特异度为65%,阳性预测值为65%,阴性预测值为35%。结论糖尿病认知功能障碍患者海马体积明显变小,其对糖尿病认知功能障碍的诊断有一定临床价值。

Objective To exlpore the value of hippocampal volume in diagnosising of diabetic mild cognitive impairment. Methods Sixty-five cases were assigned to 4 groups： 25 normal cases in control group, 20 patients with diabetes mellitus （DM） in DM group, and 20 DM patients with mild cognitive impairment （MCI） in DM＋MCI group. Cognitive function was assessed by MoCA scale. All the subjects underwent magnetic resonance imaging （MRI） to calculate hippocampal volumes. Results For left hippocampal volume, the area under the ROC curve was 2.845 cm3. For right hippocampal volume, the area under the ROC curvewas 2.875 cm3. Conclusion The volume of the hippocampus decreases in DCI patients significantly.It has a clinical value in diagnosis of diabetes mellitus with diabetic mild cognitive impairment.