2型糖尿病患者血糖及相关危险因素与认知功能障碍的关系
发布时间：2018-08-20 14:16
【摘要】：目的：通过对2型糖尿病(T2DM)患者的回顾性调查,了解控制血糖及其他相关危险因素对认知功能障碍(CI)的影响,探讨早期防治糖尿病合并认知功能障碍的方法。 方法：连续选取门诊及体检中心T2DM患者129例,根据其认知功能评分(Mini. Mental State Examination, MMSE)分为3组：认知功能正常组,轻度认知功能障碍组(mild cognitive impairment,MCI)及痴呆组,将3组病例再根据糖化血红蛋白数值各分为血糖控制满意和控制不良组,对各组随访一年前后认知功能程度的变化进行比较。再将认知功能正常组,轻度认知功能障碍组(1nild cognitive impairment,MCI)及痴呆组3组病例根据高血压的诊断标准各分为合并高血压组与不合并高血压组,对各组随访前后认知功能程度的变化进行比较。数据分析用SPSS11.5统计学软件完成,计量资料采用均数±标准差(x±s)表示,两组间均数比较采用t检验,计数资料比较采用x2检验,P0.05认为差异有显著性。 结果： 1.随访一年后,认知功能正常组,轻度认知功能障碍组及痴呆组与初诊资料构成比的比较,血糖控制组认知功能障碍程度均好于控制不良组,采用x2检验,P0.05,差异有显著性。 2.初诊时,认知功能正常组,轻度认知功能障碍组及痴呆组中血糖控制不良组较控制满意组CMS水平低,差异有统计学意义,(P0.05)。 随访1年后,三组中血糖控制不良组MMSE、CMS、指向记忆、联想学习、图象自由回忆、无意义图形再认、人像特点回忆水平均低于同期血糖控制满意组,差异有统计学意义,(P0.05)。 随访1年后与初诊资料的组间比较中,血糖控制组,只有人像特点回忆水平下降较一年前有所下降,,差异有统计学意义(P0.05)：而血糖控制不良组,MMSE、CMS、指向记忆、联想学习、图象自由回忆、无意义图形再认、人像特点回忆水平均低于一年前期血糖控制满意组,差异有统计学意义,(P0.05)。 3.随访一年后,认知功能正常组,轻度认知功能障碍组及痴呆组与初诊资料构成比的比较,不合并高血压组认知功能障碍程度均好于合并高血压组,采用x2检验,P0.05,差异有显著性。 4.初诊时,认知功能正常组,轻度认知功能障碍组及痴呆组中合并高血压组MMSE及MoCA评分均低于不合并高血压组,差异有统计学意义,(P0.05)。 随访一年后,认知功能正常组,轻度认知功能障碍组及痴呆组中合并高血压组MMSE及MoCA评分均低于同期不合并高血压组,差异有统计学意义,(P0.05)。 随访一年后,认知功能正常组,轻度认知功能障碍组及痴呆组中相同血压情况的随访病(?)MMSE及MoCA评分均低于初诊病例,差异有统计学意义,(P0.05)。 结论： 1.血糖控制不良可增加糖尿病患者认知功能障碍的进展。 2.血糖控制不良可使记忆功能损伤的范围明显扩大。 3.糖尿病合并高血压,可进一步促加重认知功能障碍的进展。 4.良好的血糖和血压控制会有效的预防糖尿病合并认知功能障碍的进展。
[Abstract]:Objective: To investigate the effect of blood glucose control and other related risk factors on cognitive impairment (CI) in patients with type 2 diabetes mellitus (T2DM), and to explore the methods of early prevention and treatment of diabetes mellitus complicated with cognitive impairment.
Methods: A total of 129 T2DM patients in outpatient and physical examination centers were divided into three groups according to their cognitive function score (MMSE): normal cognitive function group, mild cognitive impairment (MCI) group and dementia group. The patients with normal cognitive function, mild cognitive impairment (MCI) and dementia were divided into hypertension group and non-hypertension group according to the diagnostic criteria of hypertension. The data analysis was performed by SPSS11.5 statistical software. The mean (+ standard deviation) was used to express the measurement data. The t test was used to compare the mean between the two groups. The x2 test was used to compare the counting data. P 0.05 showed that the difference was significant.
Result:
1. After a year of follow-up, the cognitive impairment of normal group, mild cognitive impairment group and dementia group was better than that of poor control group. The difference was significant by x2 test (P 0.05).
2. At the initial diagnosis, the CMS level in the normal cognitive function group, mild cognitive impairment group and dementia group was lower than that in the satisfactory control group (P 0.05).
After 1 year follow-up, MMSE, CMS, directional memory, associative learning, free recall of images, recognition of meaningless graphics, and recall of portrait characteristics in the three groups were significantly lower than those in the same period of glycemic control satisfaction group (P 0.05).
After 1 year of follow-up, compared with the first visit, the recall level of the blood glucose control group was lower than that of one year ago, and the difference was statistically significant (P 0.05). There was statistically significant difference in the pre - glucose control group (P0.05).
3. After a year of follow-up, the proportion of cognitive impairment in normal group, mild cognitive impairment group and dementia group was better than that in hypertension group. The difference was significant by x2 test (P 0.05).
4. At the initial diagnosis, MMSE and MoCA scores of normal cognitive function group, mild cognitive impairment group and dementia group with hypertension were lower than those of non-hypertension group (P 0.05).
After a year of follow-up, the scores of MMSE and MoCA in normal cognitive function group, mild cognitive impairment group and dementia group with hypertension were lower than those in non-hypertension group (P 0.05).
After one year of follow-up, the scores of MMSE and MoCA in the patients with normal cognitive function, mild cognitive impairment and dementia were lower than those in the patients with initial diagnosis (P 0.05).
Conclusion:
1. poor glycemic control can increase the progression of cognitive dysfunction in diabetic patients.
2. impaired glucose control can significantly increase the range of memory impairment.
3. diabetes and hypertension can further promote the progression of cognitive dysfunction.
4. good glycemic control and blood pressure control can effectively prevent the progression of diabetes combined with cognitive impairment.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.1
[Abstract]:Objective: To investigate the effect of blood glucose control and other related risk factors on cognitive impairment (CI) in patients with type 2 diabetes mellitus (T2DM), and to explore the methods of early prevention and treatment of diabetes mellitus complicated with cognitive impairment.
Methods: A total of 129 T2DM patients in outpatient and physical examination centers were divided into three groups according to their cognitive function score (MMSE): normal cognitive function group, mild cognitive impairment (MCI) group and dementia group. The patients with normal cognitive function, mild cognitive impairment (MCI) and dementia were divided into hypertension group and non-hypertension group according to the diagnostic criteria of hypertension. The data analysis was performed by SPSS11.5 statistical software. The mean (+ standard deviation) was used to express the measurement data. The t test was used to compare the mean between the two groups. The x2 test was used to compare the counting data. P 0.05 showed that the difference was significant.
Result:
1. After a year of follow-up, the cognitive impairment of normal group, mild cognitive impairment group and dementia group was better than that of poor control group. The difference was significant by x2 test (P 0.05).
2. At the initial diagnosis, the CMS level in the normal cognitive function group, mild cognitive impairment group and dementia group was lower than that in the satisfactory control group (P 0.05).
After 1 year follow-up, MMSE, CMS, directional memory, associative learning, free recall of images, recognition of meaningless graphics, and recall of portrait characteristics in the three groups were significantly lower than those in the same period of glycemic control satisfaction group (P 0.05).
After 1 year of follow-up, compared with the first visit, the recall level of the blood glucose control group was lower than that of one year ago, and the difference was statistically significant (P 0.05). There was statistically significant difference in the pre - glucose control group (P0.05).
3. After a year of follow-up, the proportion of cognitive impairment in normal group, mild cognitive impairment group and dementia group was better than that in hypertension group. The difference was significant by x2 test (P 0.05).
4. At the initial diagnosis, MMSE and MoCA scores of normal cognitive function group, mild cognitive impairment group and dementia group with hypertension were lower than those of non-hypertension group (P 0.05).
After a year of follow-up, the scores of MMSE and MoCA in normal cognitive function group, mild cognitive impairment group and dementia group with hypertension were lower than those in non-hypertension group (P 0.05).
After one year of follow-up, the scores of MMSE and MoCA in the patients with normal cognitive function, mild cognitive impairment and dementia were lower than those in the patients with initial diagnosis (P 0.05).
Conclusion:
1. poor glycemic control can increase the progression of cognitive dysfunction in diabetic patients.
2. impaired glucose control can significantly increase the range of memory impairment.
3. diabetes and hypertension can further promote the progression of cognitive dysfunction.
4. good glycemic control and blood pressure control can effectively prevent the progression of diabetes combined with cognitive impairment.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.1
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