2型糖尿病患者认知功能障碍与糖尿病自主神经病变的相关性研究

Relationship Study Between Cognitive Dysfunction and Autonomic Neuropathy of Type 2 Diabetes Patients

目的 探讨2型糖尿病患者认知功能障碍与糖尿病自主神经病变的相关性。方法 选取2022年1—12月本院治疗的120例2型糖尿病(T2MD)患者作为研究对象。根据有无心血管自主神经病变(CAN)进行分组,对照组(n=70)无CAN,观察组(n=50)有CAN,对比两组MMSE和MoCA量表检查结果、COMPASS-31量表检查结果;根据是否存在认知功能障碍进行分组,A组(n=82)无认知功能障碍,B组(n=38)有认知功能障碍,对比各项生化指标。结果 观察组MMSE评分、MoCA评分均低于对照组(P<0.05);观察组直接不耐受、血管舒缩、分泌活动、胃肠道、膀胱、瞳孔运动等COMPASS-31评分均高于对照组(P<0.05);B组FBG、HbA1c、TC、TG、LDL-C、HDL-C、空腹C肽与A组相当(P>0.05),但餐后2h C肽低于A组,CAN比例高于A组(P<0.05);COMPASS-31评分与MMSE评分、MoCA评分呈负相关(r=-0.176,-0.168,P<0.05)。结论 T2MD患者认知功能障碍与CAN存在显著关联,CAN可增加认知功能障碍发生风险。

Objective To investigate correlation between cognitive dysfunction and autonomic neuropathy of type 2 diabetes patients.Methods The paper chose 120 patients with type 2 diabetes mellitus(T2MD)in our hospital from January 2022 to December 2022 as study subjects,and divided them into groups according to condition of cardiovascular autonomic neuropathy(CAN).Control group(n=70)had no CAN,and observation group(n=50)had CAN.Results of MMSE and MoCA scales and COMPASS-31 scale were compared between two groups.Patients were grouped according to cognitive dysfunction condition.Group A(n=82)had no cognitive dysfunction,group B(n=38)had cognitive impairment,Various blood biochemical indicators were compared.Results MMSE scores and MoCA scores of observation group were lower than control group(P<0.05).COMPASS-31 scores of direct intolerance,vasoconstriction,secretion activity,gastrointestinal tract,bladder,and pupil movement in observation group were higher than control group(P<0.05).FBG,HbA1c,TC,TG,LDL-C,HDL-C,and fasting C-peptide levels in group B were comparable to group A(P>0.05),but after 2 hours of meals,C-peptide levels in group A were lower and CAN ratio was higher,(P<0.05).COMPASS-31 scores were negatively correlated with MMSE scores and MoCA scores(r=-0.176,-0.168,P<0.05).Conclusion There is significant correlation between cognitive dysfunction and CAN of T2MD patients,CAN can increase risk of cognitive dysfunction.