【摘要】：背景糖尿病在中國(guó)已呈現(xiàn)流行趨勢(shì),糖尿病的慢性并發(fā)癥對(duì)患者、家庭、社會(huì)造成大量的負(fù)擔(dān)。糖尿病輕度認(rèn)知功能障礙(mild cognition impairment,MCI)也是其慢性并發(fā)癥之一。其作為癡呆的早期階段如果能給予有效的干預(yù)可延緩其發(fā)生。有很多因素可導(dǎo)致糖尿病MCI發(fā)生,了解其中相關(guān)危險(xiǎn)因素,對(duì)干預(yù)及延緩糖尿病MCI的發(fā)展有重要的意義。目的了解2型糖尿病患者的認(rèn)知功能及輕度認(rèn)知功能障礙的患病現(xiàn)狀,探討糖尿病輕度認(rèn)知功能障礙發(fā)生的相關(guān)因素。方法本研究自2014年10月至2015年12月共收集樣本95例,其中67例糖尿病組為就診于常熟市第二人民醫(yī)院內(nèi)分泌科和蘇州大學(xué)附屬第二醫(yī)院內(nèi)分泌科的確診為2型糖尿病的患者,其中男性34例,女性33例,平均年齡為64.1±9.2歲。對(duì)照組28例為就診于常熟市第二人民醫(yī)院老干部病區(qū)的非糖尿病人群,其中男性15例,女性13例,平均年齡為60.8±8.5歲。利用蒙特利爾認(rèn)知評(píng)估量表(Montreal Cognitive Assessment,MoCA)評(píng)定患者的認(rèn)知功能,統(tǒng)計(jì)收集的各種變量,數(shù)據(jù)由SPSS 13.0軟件進(jìn)行處理,兩者之間的分類資料采用Χ2檢驗(yàn),兩組之間計(jì)量資料的比較采用獨(dú)立t檢驗(yàn),相關(guān)因素采用Logistic回歸分析。結(jié)果糖尿病組的MoCA評(píng)分低于對(duì)照組,MoCA以26分為診斷輕度認(rèn)知功能障礙的界值時(shí),糖尿病組的MCI發(fā)生率(77.6%)顯著高于對(duì)照組(39.3%),差異具有統(tǒng)計(jì)學(xué)意義(P0.001)。單因素logistic回歸顯示,糖尿病與MCI為正相關(guān)(OR=5.358,95%CI:2.069-13.873,P=0.001),年齡(≤60歲)與MCI為負(fù)相關(guān)(OR=0.300,95%CI=0.124-0.728,P=0.008)、文化程度(小學(xué)及以下)與MCI正相關(guān)(OR=57.773,95%CI:7.381-452.193,P0.0001)、頸動(dòng)脈斑塊與MCI為正相關(guān)(OR=3.786,95%CI:1.38-12.592,P=0.03)。糖尿病輕度認(rèn)知功能障礙組(MCI組)與糖尿病正常組(NC組)在進(jìn)行多因素logistic回歸分析顯示空腹血糖的控制(≥7mmol/l)與糖尿病MCI發(fā)生為正相關(guān)(OR=8.425,95%CI=1.133-62.626,P=0.037),文化程度(小學(xué)及以下)與糖尿病MCI發(fā)生為正相關(guān)(OR=24.468,95%CI=2.468-242.6,P=0.006)。結(jié)論1.2型糖尿病患者發(fā)生輕度認(rèn)知障礙風(fēng)險(xiǎn)明顯升高,2型糖尿病是輕度認(rèn)知功能障礙發(fā)生的危險(xiǎn)因素。2.2型糖尿病患者擁有高文化程度為糖尿病MCI的保護(hù)因素,糖尿病患者空腹血糖水平控制不佳為糖尿病MCI發(fā)生的獨(dú)立危險(xiǎn)因素。
[Abstract]:Background Diabetes mellitus has been prevalent in China. The chronic complications of diabetes cause a great deal of burden to patients, families and society. Diabetes mellitus with mild cognitive impairment (mild cognition impairment,MCI) is also one of its chronic complications. As an early stage of dementia, it can be delayed if effective intervention is given. There are many factors leading to the development of diabetic MCI. It is important to understand the related risk factors and to intervene and delay the development of diabetic MCI. Objective to investigate the cognitive function of type 2 diabetes mellitus (DM) and the prevalence of mild cognitive dysfunction (MCI), and to explore the related factors of MCI in type 2 diabetes mellitus (DM). Methods from October 2014 to December 2015, a total of 95 patients with type 2 diabetes were collected. Among them, 67 patients with diabetes mellitus were diagnosed as type 2 diabetes in the Endocrinology Department of the second people's Hospital of Changshu City and the Endocrinology Department of the second affiliated Hospital of Suzhou University. There were 34 males and 33 females with an average age of 64.1 鹵9.2 years. The control group (n = 28) was a non-diabetic group, including 15 males and 13 females, with an average age of 60.8 鹵8.5 years. The cognitive function of patients was assessed by Montreal Cognitive Assessment scale (Montreal Cognitive Assessment,MoCA). The data collected were processed by SPSS 13.0 software. The classified data between them were tested by X 2 test. The measurement data of the two groups were compared by independent t test, and the related factors were analyzed by Logistic regression analysis. Results the MoCA score in the diabetic group was lower than that in the control group. The incidence of MCI in the diabetic group (77.6%) was significantly higher than that in the control group (39.3%) when MoCA was classified as the threshold value for the diagnosis of mild cognitive impairment (P0.001). The difference was statistically significant (P0.001). Univariate logistic regression showed that diabetes mellitus was positively correlated with MCI (OR=5.358,95%CI:2.069-13.873,P=0.001), age (鈮，

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